A systematic review of counselling for HIV testing of pregnant women

Minnie, Karin; Walt, S J Christa van der; Klopper, Hester C.

doi:10.1111/j.1365-2702.2009.02805.x

Cited by 10 publications

(9 citation statements)

References 48 publications

(90 reference statements)

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“…A systematic review of factors affecting counseling and HIV testing, mainly from Africa, suggests that provider-initiated counseling and testing, group pre-test counseling sessions and rapid HIV testing with same-day results increase the uptake of counseling and testing [66]. However, another systematic review of South African studies suggests that in addition to these factors quality of counseling and contextual factors such as HIV prevalence, human and physical resources significantly affect counseling, and the review recommends that best available evidence from research studies regarding these factors should be used to develop guidelines for the local context [67]. While a family-centered approach in implementing PMTCT and integration of the PMTCT program with other services has been generally recommended in many countries including India [17,68], a recent review by Cochrane on the efficacy of integrating PMTCT with other services argued that evidence from resource-poor countries does not allow one to conclude that integrated care is more effective than non-integrated or partially integrated care.…”

Section: Discussionmentioning

confidence: 99%

Systematic review of public health research on prevention of mother-to-child transmission of HIV in India with focus on provision and utilization of cascade of PMTCT services

et al. 2012

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BackgroundIn spite of effective strategies to eliminate mother-to-child-transmission of HIV, the implementation of such strategies remains a major challenge in developing countries. In India, programs for the prevention of mother-to-child transmission (PMTCT) have been scaled up widely since 2005. However, these programs reach only a small percentage of pregnant women, and their overall effectiveness is low. Evidence-based program planning and implementation could significantly improve their effectiveness. This study sought to systematically retrieve, thematically categorize and review published research on PMTCT of HIV in India, focusing on research related to the provision and/or utilization of the cascade of services provided in a PMTCT program, in order to direct further research to enhance program implementation and effectiveness.MethodsA systematic search using MEDLINE, US National Library of Medicine Gateway system (PubMed) and ISI Web of Knowledge resulted in 1,944 abstracts, of which 167 met our inclusion criteria.ResultsA huge share of the empirical literature on PMTCT in India (N = 134) deals with epidemiological studies (N = 60). The 46 papers related to utilization/provision of the cascade of PMTCT services were mostly from the four high HIV prevalence states in southern India and from the public sector. Studies on experiences of implementing a PMTCT program (N = 20) show high rates of drop out of women in the cascade particularly prior to receiving ARV. Studies on individual components of the cascade (N = 26) show that HIV counseling and testing is acceptable and feasible. Literature on other components of the cascade - such as pregnant women’s access to ANC care, HIV infected women’s immunological assessment using CD4 testing, repeat HIV testing among pregnant women, early infant diagnosis and factors related to linking HIV infected women and children to postnatal care – is lacking.ConclusionsWhile the scale of the Indian PMTCT program is large, comprehensive understanding of the context-driven factors affecting its efficiency is lacking. Systematic and more focused public health research output is needed on the issues related to reduction of drop outs of women in the cascade, role of PMTCT programs in improving maternal and child health indicators and role of private sector in delivering PMTCT services.

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Section: Discussionmentioning

confidence: 99%

Systematic review of public health research on prevention of mother-to-child transmission of HIV in India with focus on provision and utilization of cascade of PMTCT services

et al. 2012

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“…Another important feature of this part of Africa is the high prevalence of HIV infection, especially among pregnant women, with prevalence rates approaching 28% [84,85]. Nevertheless, the prevalence of coinfection was low (0.001%-0.1%) [86,87].…”

Section: Southern Regionmentioning

confidence: 99%

Hepatitis B and C virus infections among pregnant women in Arab and African countries

Gasim

Murad

Adam

2013

J Infect Dev Ctries

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Introduction: The epidemiology of viral hepatitis during pregnancy is of paramount importance for health planners and program managers. Data on viral hepatitis during pregnancy are not readily available in many African and Arab countries. Both regions have their own unique geography, and comprise over 59 states with crossover and interaction of different cultures. Methodology: A systematic electronic search of the published literature was conducted and data on epidemiology and risk factors of maternal hepatitis B virus (HBV) infection and hepatitis C (HCV) infection in Arab and African countries were extracted from relevant studies. Results: The serology of hepatitis viruses varies greatly among these countries, with different viral genotype patterns. Such a variation in prevalence could be explained by the different risk factors involved. Sexual contact, perinatal infection, blood and its derivatives, hemodialysis, intravenous and percutaneous drug use, and occupational, habitual, and social behavior have been identified as risk factors for hepatitis transmission in various settings in these countries. Conclusions: Infection from hepatitis B and C viruses imposes major socioeconomic and even political burdens on such young and dynamic societies. Thus strategies and clear policies of intervention are required to combat the consequences of hepatitis B and C at both the regional and national levels.

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“…In a systematic review of counselling for HIV testing in pregnancy, Minnie et al . identified 33 studies, but none discussed partner testing, other than reference to desirability of couple testing [29]. …”

Section: Introductionmentioning

confidence: 99%

“…Although some studies raise fears of abuse and negative outcomes for women, Semrau et al in Zambia showed that couple counselling did not increase the risk of adverse social events for women [28]. In a systematic review of counselling for HIV testing in pregnancy, Minnie et al identified 33 studies, but none discussed partner testing, other than reference to desirability of couple testing [29].…”

Section: Introductionmentioning

confidence: 99%

Involving fathers in prevention of mother to child transmission initiatives – what the evidence suggests

Sherr

Croome

2012

Journal of the International AIDS Society

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IntroductionThe current UNAIDS goal towards virtual ending or elimination of infants acquiring HIV by 2015 is perhaps the most achievable goal to date. Yet, models show that delivery of antiretroviral compounds alone will not suffice to achieve this goal, and a broader community-based approach to pregnancy, families and HIV is needed. Such an approach would highlight the important role of men in reproduction. Although early studies have shown it is cost-effective to include males, very few interventions have proceeded to involve men.MethodsThis review utilized systematic review techniques to explore the literature on effective interventions for the inclusion of men in the prevention of HIV to infants. A key word search of literature sources generated 248 studies for hand sorting and interrogation. Of these, 13 were found to contain some information on involvement of males in some form of provision. Data were abstracted from these and form the basis of this review.ResultsBackground descriptive studies painted a picture of low male involvement, poor male inclusion and barriers to engagement at all stages. Yet, pregnancy intentions among men affected by HIV are high and the importance of fathers to family functioning – from relationships, through conception, pregnancy and parenting – is well established. Search strategies for interventions for males in HIV and pregnancy were used to generate studies of sufficient quality to inform strategies on the future of male involvement. Of the 317,434 papers on pregnancy and HIV, only 4178 included the term male (paternal or father). When these were restricted to intervention studies, only 248 remained for hand sorting, generating 13 studies of relevance for data extraction. The results show that all these interventions were concentrated around male partner HIV testing. In general, male partner testing was low and was amenable to change by offering voluntary counselling and testing (VCT) information, providing couple-based testing facilities and encouraging male attendance. All interventions used indirect approaches to men via their pregnant spouse. Non-health facility (clinic or hospital)-based provision (such as testing facilities in the community in bars and churches) were more effective than healthcare facilities in attracting male participation.ConclusionsIn conclusion, the review showed that approaches to men are limited to HIV testing with little innovative planning and provision for male treatment and care. As such, initiatives run the risk of alienating rather than including males. Direct approaches and the provision of male-specific facilities and benefits should be explored.

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A systematic review of counselling for HIV testing of pregnant women

Abstract: Implementation of the best practice guidelines may lead to the increased uptake of HIV testing in pregnancy in developing countries like South Africa and thus to an increase in the number of women whose status is known when their babies are born.

Cited by 10 publications

References 48 publications

Systematic review of public health research on prevention of mother-to-child transmission of HIV in India with focus on provision and utilization of cascade of PMTCT services

Systematic review of public health research on prevention of mother-to-child transmission of HIV in India with focus on provision and utilization of cascade of PMTCT services

Hepatitis B and C virus infections among pregnant women in Arab and African countries

Involving fathers in prevention of mother to child transmission initiatives – what the evidence suggests

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