Inadequate counselling stymies PMTCT

The poor counselling offered to HIV-positive pregnant women is limiting the effectiveness of the government's programme to reduce mother-to-child transmission of the HI-virus. Counsellors failed to communicate all the facts women needed to make an informed choice, and practise that choice safely and successfully, according to a study by the South African Medical Research Council (MRC), Health Systems Trust (HST) and the University of the Western Cape. As a result, only a third of the women who chose to use formula milk were provided with instructions, and none of the women who chose exclusive breastfeeding could define what the term meant. "Counselling offered at prevention of mother-to-child transmission (PMTCT) programme sites falls short of the mark," Tanya Doherty, a PMTCT research officer with the HST, told delegates at the 2nd South African AIDS Conference in the east-coast city of Durban. Research has conclusively shown that, next to birth, mixing breastfeeding and formula feeding carry the highest risk of HIV transmission. Women therefore have to be advised to choose either exclusive breastfeeding, with early weaning at three to four months, or formula feeding if they have access to fuel and clean drinking water to prepare the mixture safely.