AEGiS-15IAC: Social and Community Factors in Accessing PMTCT Services.

15th International AIDS Conference

Bangkok, Thailand - July 11-16, 2004

Social and Community Factors in Accessing PMTCT Services.

Int Conf AIDS 2004 Jul 11-16; 15:(abstract no. E10194)

Varga CA, Brookes H, Sherman G, Jones S
University of Minnesota, Minneapolis, United States

ISSUES: In keeping with the theme of "access for all" this paper reviews lessons learned concerning community access to prevention of mother-to-child HIV prevention services (PMTCT) in sub-Saharan Africa. Currently PMTCT interventions receive considerable attention from health systems and clinical epidemiological forums. An equally important consideration is social and community issues with the potential to affect the implementation and efficacy of PMTCT interventions.

DESCRIPTION: We briefly review existing literature in sub-Saharan Africa concerning completed work and lesson learned about social and community dynamics surrounding PMTCT. We then provide a local perspective through an overview of results from recently completed community-based studies of PMTCT in South Africa. Finally, we address gaps and priorities relevant for PMTCT research, programming, and policy.

LESSONS LEARNED: Results of existing studies - including our South African work - reveal a consistent picture of social and community factors relevant to PMTCT interventions. This includes the need to 1) improve both basic HIV/AIDS knowledge and awareness of PMTCT-specific facts; 2) address HIV/AIDS stigma; 3) address gender relations and encourage male participation; 4) recognize group decision-making mechanisms; 5) address cultural beliefs surrounding infant care; 6) encourage local preparedness for and participation in research and programming; 7) recognize the influence of household and family structure, and residency and migration patterns.

RECOMMENDATIONS: Consideration of community and social factors is vital to accessibility and effectiveness of PMTCT interventions. The evidence provides an argument for re-structuring programs to ensure a better "fit" between health systems and the needs of communities they serve. Explicit mention of social and community issues in PMTCT policy is timely given that developing countries such as South Africa are currently drafting new legislation.

Keywords: AEGIS, Residence Characteristics, Africa South of the Sahara, Acquired Immunodeficiency Syndrome, HIV Infections, Developing Countries, Family Characteristics, Demography, Public Policy, Culture, HIV Seropositivity, Anti-HIV Agents, Research, Interpersonal Relations, South Africa, Child, Humans, Infant, Male

040711
E10194