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Evolution of the Quality of HIV Pre-test Counselling to Prevent Mother-to-Child Transmission of HIV from 2007 to 2016 in Cotonou (Benin)

Background: Data from Benin’s PMTCT program indicate that 15% to 30% of women who have undergone prenatal consultation were not screened between 2005 and 2016. The testing rate varies greatly from one site to the other. Furthermore, the quality of the counselling during screening may vary significantly which is a concern.

Objective: This is to assess the quality of pre-test counselling between 2007 and 2016 within various organisational contexts in Benin. Hence, we sought to compare what has been achieved in maternity units to the program model.

Method: Quality of pre-test counselling concerns the content and the communication model. We combined a survey to a qualitative study in 2007 and 2016. For the cross-sectional survey, pregnant women were recruited. The qualitative data were collected in semidirected interviews and through non-participant observation.

Results: At the public sites, there are regular group counselling sessions, which provide the women with a considerable amount of information. The percentage of pregnant women who attended group counselling is nevertheless low at the private sites, where the quality of counselling is poor. Between 2007 and 2016, the quality improved in public health centers, unlike in private hospitals.

Conclusion: It is crucial that women understand the issues related to screening before acceptance, since there is considerable stigmatization attached to infection in lowand middle-income countries. However, it is deplorable that counselling is so limited in terms of information provided to women and the forms of pre-test counselling at the private sites.


Marius N Kedote, Charles Sossa Jerome, Astrid Brousselle, François Champagne

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