Best practice guidelines for counselling for HIV testing during pregnancy
Minnie, Catharina Susanna
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The 2005 National survey indicates that 30,2 % of South African pregnant women are HIV positive. The risk of transmission to their infants is about 30% unless prevention interventions are applied. The Nevirapine regime, safe intraparturn practices and safe infant feeding methods could limit the risk of mother-tochild transmission to 7%. Antiretroviral treatment is available to women who can afford it and women who qualify for subsidised medication. However, HIV positive women and their infants can only benefit from these strategies when their HIV status is known. Yet only about 50% of pregnant women consent to HIV testing after counselling. Contextual factors, organisational circumstances and pregnant women's personal circumstances determine whether they are tested. This research aimed to develop best practice guidelines for pretest counselling during pregnancy. This was achieved through four objectives: exploring and describing the factors that influence pregnant women's decision to be tested in selected antenatal clinics in the North West Province, identifying the factors that influence HIV counselling during pregnancy according to counsellors who practice in these clinics, exploring the current practices regarding counselling for HIV testing during pregnancy in the selected clinics, investigating research evidence regarding counselling for HIV testing during pregnancy by means of systematic review and finally developing best practice guidelines for counselling for HIV testing during pregnancy. The research followed specific steps that consisted of two phases. Phase 1 was subdivided into four steps that related to the first four objectives and compiled evidence towards formulating best practice guidelines in phase 2. Data-collection methods included semi-structured interviews, semi-structured observation and a systematic review. Phase 1's conclusions were integrated and synthesised as base for developing best practice guidelines in Phase 2. These guidelines were graded and recommendations for implementation were formulated. Finally, the research was evaluated, limitations were identified and recommendations were formulated for nursing practice, education and - research.
- Health Sciences