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M.L. Sac Ixcot 1 , J.M. Ikeda 2 , N. Hearst 3

7. INTEGRATION OF HIV VOLUNTARY COUNSELING AND TESTING IN ANTENATAL CONTROL IN COMMUNITY CLINICS IN RURAL GUATEMALA. M.L. Sac Ixcot 1 , J.M. Ikeda 2 , N. Hearst 3

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M.L. Sac Ixcot 1 , J.M. Ikeda 2 , N. Hearst 3

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  1. 7 INTEGRATION OF HIV VOLUNTARY COUNSELING AND TESTING IN ANTENATAL CONTROL IN COMMUNITY CLINICS IN RURAL GUATEMALA M.L. Sac Ixcot1, J.M. Ikeda2, N. Hearst3 1Asociación de Investigación, Desarrollo y Educación Integral (IDEI), Monitoreo y Evaluación, Quetzaltenango, Guatemala, 2Asociación de Investigación, Desarrollo y Educación Integral (IDEI), Dirección, Quetzaltenango, Guatemala, 3 Universityof California at San Francisco, UnitedStates

  2. 7 Prevention of mother to child transmission in Guatemala • Almost 80% of the antenatal control and deliveries are carried out in the distant communities and not in the national hospitals. Thus, we integrated HIV voluntary counseling and testing (VCT) among pregnant women who attended antenatal control in community clinics in rural Guatemala, through bilingual counselors. • From October to December 2007, we integrated HIV voluntary counseling and testing in three rural community clinics in Southwestern Guatemala. The pregnant women were provided with voluntary counseling and informed consent before taking 5 ml of blood and testing it with the Abott Determine rapid test.

  3. 7 Objectives • Prevent HIV mothertochildtransmissionbyoffering confidencial and free HIV counseling and testing as part of antenatal control in rural, communityhealthclinicsthatprovide maternal and childhealthservices. • Informpregnantwomenduringtheir antenatal control about HIV prevention and treatmentformothertochildtransmission. • Providecounseling and testing in maternal mayan languagesfor HIV, Hepatitis B and Sifilis and refer HIV positive pregnantwomentointegratedcareclinicsforfollow-up and antirretroviral therapytopreventmothertochild HIV transmission.

  4. 7 Lessons learned All 114 pregnant women (17 to 42 years old) who were given voluntary counseling provided informed consent for the HIV exam. Only 0.9% was HIV positive and referred to the integrated care clinic. 64% could mention at least 3 symptoms of STIs; 83% mentioned that HIV is transmitted by sexual relations, however only 24% of the women mentioned that HIV could be transmitted by blood transfussion. 23% knew that women could transmit HIV from mother to child, and. 73% reported being at risk for HIV infection due to the fact that they have unprotected sex with their husbands. And more thanone-half of theinterviewedwomenstatedthattheyknew o werevictims of sexual violenceorcohersion. Thebasic HIV knowledgewaspoor and requiresfollow-up: • HIV transmissionformsand principallymothertochildtransmissionthat can affectthewoman and thechildwhilepregnant. • Beingabletoidentifysexuallytransmittedinfectionssymptoms and receiveadequate and opportunetreatment. • Theimportance of using a condomwiththeirpartner as a measure of HIV prevention.

  5. 7 Next steps: The community clinics are an effective space for offering voluntary counseling and testing to pregnant women in rural areas. The majority of these women did not know about mother to child transmission, thus it is necessary to raise the consciousness of rural women so that they can prevent HIV transmission 97 % wishtohave more informationregardingSTIsand HIV/AIDS, statingthatitisimportanttoknowabouttheseinfections and provideourchildren and otherswithorientation so thatwe can preventtheseinfections. Prevention strategies and detection of STIs and HIV in rural area of Guatemala should take into account the cultural characteristics of the population such as: Language, beliefs, places where pregnant women go for antenatal care so that the intervention is effective.

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