n Southern African Journal of HIV Medicine - Feasibility and acceptability of postpartum voluntary counseling and testing (PPVCT) in a large tertiary hospital in the South African setting

Volume 2005, Issue 19
  • ISSN : 1608-9693
  • E-ISSN: 2078-6751



&lt;I&gt;Objective.&lt;/I&gt; To demonstrate the feasibility and acceptability of introducing postpartum voluntary counselling and testing (PPVCT) and the provision of post-exposure nevirapine prophylaxis (PEP) to HIV-exposed infants whose mothers did not receive any antiretroviral prophylaxis to prevent mother-to-child transmission (PMTCT) in a large, tertiary hospital in the South African setting. &lt;br&gt;&lt;I&gt;Design.&lt;/I&gt; Observational, interventional study. &lt;br&gt;&lt;I&gt;Setting.&lt;/I&gt; The programme was implemented at Chris Hani Baragwanath Hospital (tertiary referral centre) in Soweto, South Africa, following a study that established the efficacy of a postpartum regimen of PEP in PMTCT. &lt;br&gt;&lt;I&gt;Participants.&lt;/I&gt; From January 2003 to December 2004, 7 500 women who delivered at Chris Hani Baragwanath Hospital without a documented HIV-1 result were identified in the postnatal wards. PPVCT was offered to all eligible participants. &lt;br&gt;&lt;I&gt;Intervention.&lt;/I&gt; On-site HIV rapid tests were performed on all women who agreed to testing. For those women testing HIV-1 positive, a single dose of nevirapine syrup was offered to their infants as PEP within 72 hours after delivery. Infant feeding <br><I>counseling</I>, assistance with follow-up care and support programmes were also offered. <br><I>Main outcome.&lt;/I&gt; From January 2003 to December 2004, 34 776 deliveries occurred at Chris Hani Baragwanath Hospital. Of these, 7 500 (21.5%) had no documented HIV status. After delivery 5 751 (76.7%) women were offered VCT, and of these 3 794 (66%) accepted testing. Of these women, 1 294 (34%) tested HIV positive and 1 243 (96%) women accepted the administration of single-dose nevirapine to their infants. &lt;br&gt;&lt;I&gt;Conclusions.&lt;/I&gt; The uptake of PPVCT is comparable to that seen in established antenatal VCT despite the numerous challenges PPVCT presents. This suggests that PPVCT is both an acceptable and a feasible option in a busy, resource-limited setting and remains an important strategy in PMTCT in untreated individuals.

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