Efforts to reach pregnant mothers slowly paying off

Rosalie Salako, 38, a mother of three, meets every week with pregnant women from the district of Pobè, 120km east of Cotonou, the main coastal town in Benin, to encourage them to be tested for the HI virus.

She became involved in the prevention of mother-to-child transmission (PMTCT) of HIV programme over three years ago, when it was launched in her district. Salako, who had already had two children, went for an HIV test and was diagnosed HIV negative.

"When I was given the results [of the HIV screening] and they came back negative, I was asked to advise other pregnant women, so that they would come and take the test and find out if they had AIDS," she told IRIN/PlusNews.

"I tell the women that getting tested will allow them to give their children security and protect them against AIDS if they have contracted the virus." She also has to ensure that the HIV-positive pregnant women she advises stick to their treatment regimen, before and after the baby is born.

The work of Salako and other women like her in Pobè and the neighbouring towns, Kétou and Adja Ouère, is clearly paying off: nine out of 10 women who attend antenatal healthcare facilities in this health zone agree to be tested.

Dr Joseph Zinsou, the PMTCT coordinating doctor in the district, said the role of these advisors, who are mothers themselves, is crucial because it has enabled more pregnant women to access HIV/AIDS services.

PMTCT is widely available in maternity hospitals in Benin, and 1,171 pregnant women tested positive for HIV in 2005, with 939 receiving antiretroviral (ARV) medication.

Despite the progress she has made, Salako still struggles to convince women to use these services. She said a major barrier is the fear of upsetting their partners, and some go so far as to avoid any contact with PMTCT advisors because they are afraid of angering the men.

Zinsou acknowledged that getting men involved in the PMTCT programme has been an uphill battle. "It is the women who take the responsibility for getting tested. The husbands have not yet decided to take the test themselves. There are only a handful that have done it."

In the health zone of Pobè, Kétou and Adja Ouère, 52 percent of pregnant women have made use of PMTCT services; nationally the figure stands at 38 percent, according to UNAIDS. "This rate ... [could] be higher if the men were as dedicated as the women," lamented Zinsou.

It is the women who take the responsibility for getting tested. The husbands have not yet decided to take the test themselves.

Bernard Adéogou, a rubber worker, told IRIN/PlusNews that he has absolutely no desire to allow his wife to take the test, saying, "I don't like it, as I am scared of the results." He admitted that he did not know what PMTCT was, but nevertheless did not want to hear about it.

This reaction is common. In October 2007, UNICEF and government health officials launched a PMTCT awareness campaign in Pobè, targeting men in particular.

Widespread stigma sometimes also makes the message given by Salako and other advisors difficult to get across to the women. "When some women see the treatment given to people who are ill or known to be HIV positive, they remain very closed-off from our message," she said.

UNAIDS estimates that 1.8 percent of the country's adult population is living with HIV.

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