|dc.description.abstract||Routine HIV counselling and testing as part of antenatal care has been institutionalized in Uganda as an
entry point for pregnant women into the prevention of mother-to-child transmission of HIV (PMTCT) programme.
Understanding how women experience this mode of HIV testing is important to generate ideas on how to strengthen
the PMTCT programme. We explored pregnant HIV positive and negative women’s experiences of routine counselling
and testing in Mbale District, Eastern Uganda and formulated suggestions for improving service delivery.
Methods: This was a qualitative study conducted at Mbale Regional Referral Hospital in Eastern Uganda between
January and May 2010. Data were collected using in-depth interviews with 30 pregnant women (15 HIV positive and
15 HIV negative) attending an antenatal clinic, six key informant interviews with health workers providing antenatal care
and observations. Data were analyzed using a content thematic approach.
Results: Prior to attending their current ANC visit, most women knew that the hospital provided HIV counselling and
testing services as part of antenatal care (ANC). HIV testing was perceived as compulsory for all women attending ANC
at the hospital but beneficial, for mothers, especially those who test HIV positive and their unborn babies. Most HIV
positive women were satisfied with the immediate counselling they received from health workers, but identified the
need to provide follow up counselling and support after the test, as areas for improvement. However, most HIV negative
women mentioned that they were given inadequate attention during post-test counselling. This left them with
unanswered questions and, for some, doubts about the negative test results.
Conclusions: In this setting, routine HIV counselling and testing services are known and acceptable to mothers. There is
need to strengthen post-test and follow up counselling for both HIV positive and negative women in order to maximize
opportunities for primary and post exposure HIV prevention. Partnerships and linkages with people living with HIV,
especially those in existing support groups such as those at The AIDS Support Organization (TASO), may help to
strengthen counselling and support for pregnant women. For effective HIV prevention, women who test HIV negative
should be supported to remain negative.||en_US