Prevention of mother-to-child transmission of HIV in Africa

Abstract

Before implementation of a tolerance and efficacy trial of zidovudine (ZDV) in Abidjan Ivory Coast the acceptability of HIV screening was probed among women attending the Yopougon Health Center for their first prenatal visit in 1996-97. Of the 2219 prenatal clients who were eligible for AZT 395 (17.8%) refused HIV testing--primarily because of fear of the result. Of the 1824 women who consented to testing 279 (15.3%) were HIV-positive (249 for HIV-1 21 for HIV-2 and 9 with dual reactions). 204 HIV-positive women returned for their test result. Of these women 3 refused the confirmation test and 29 were lost to follow-up after the second test leaving 172 women for pre-inclusion. However 101 of these women were subsequently excluded for reasons including return visit too late in pregnancy for AZT planned delivery outside of Abidjan change of mind and loss to follow-up before formal inclusion. Thus only 71 women received the trial treatment. The only significant difference between these 71 women and those who did not complete the selection process was that the former women were older (mean age 26 years) than the latter (mean age 24 years). The finding that it was necessary to perform HIV tests in 1824 women to recruit 71 women for a clinical trial of ZDV indicates a need for IEC campaigns aimed at women of childbearing age about maternal-child HIV transmission and its prevention.