Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Sep 4;17(1):71.
doi: 10.1186/s12905-017-0427-6.

Awareness, attitudes and perceptions regarding HIV and PMTCT amongst pregnant women in Guinea-Bissau- a qualitative study

Noel Vieira  1 , Dlama Nggida Rasmussen  2   3 , Inês Oliveira  2 , Aureliano Gomes  2 , Peter Aaby  2   4 , Christian Wejse  2   5 , Morten Sodemann  2   3 , Lucy Reynolds  6 , Holger W Unger  2   7   8
Affiliations

Awareness, attitudes and perceptions regarding HIV and PMTCT amongst pregnant women in Guinea-Bissau- a qualitative study

Noel Vieira et al. BMC Womens Health. .

Abstract

Background: The human immunodeficiency virus (HIV) continues to be a major cause of maternal and infant mortality and morbidity in sub-Saharan Africa. Prevention of mother-to-child transmission of HIV (PMTCT) strategies have proven effective in decreasing the number of children infected in utero, intrapartum and during the breastfeeding period. This qualitative study explores knowledge and perceptions of HIV amongst pregnant women, healthcare workers' experiences of the national PMTCT services, and barriers to PMTCT, during a period of programme scale-up in urban Guinea-Bissau (2010-11).

Methods: In-depth interviews were undertaken amongst 27 women and 19 key informants at local antenatal clinics and the national maternity ward in Bissau, Guinea-Bissau.

Results: Amongst women who had been tested for HIV, awareness and knowledge of HIV and PMTCT remained low. Testing without informed consent was reported in some cases, in particular when the test was performed around the time of delivery. Possible drivers of inadequate counselling included lack of confidentiality, suboptimal healthcare worker training, lack of time, and perceived occupational risk. Demand-side barriers to PMTCT included lack of HIV and PMTCT knowledge, customary and cultural beliefs associated with HIV and ill-health, HIV stigma and discrimination, and fear of partnership dissolution.

Conclusions: Socio-cultural and operational challenges, including HIV testing without informed consent, present significant barriers to the scale-up of PMTCT services in Bissau. Strengthening local capacity for effective counselling and testing in the antenatal setting is paramount. Further research into local customary beliefs relating to HIV is warranted.

Keywords: Awareness; Barriers; Guinea-Bissau; HIV; Knowledge; PMTCT.

PubMed Disclaimer

Conflict of interest statement

Ethics approval and consent to participate

The Ethics Committee of the Ministry of Health of Guinea-Bissau (NCP6/2009) and the Ethics Committee of the London School of Hygiene and Tropical Medicine approved this study. Verbal informed consent was obtained for all participants.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
The former Bissau HIV clinic, located just adjacent to the Simao Mendes National Hospital Maternity ward, surrounded by a bamboo fence to provide ‘visual’ confidentiality
Fig. 2
Fig. 2
Findings for the in-depth interviews with women and key-informants. Dotted lines indicate themes observed in other, similar research
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Kendall T, Danel I, Cooper D, Dilmitis S, Kaida A, Kourtis AP, et al. Eliminating preventable HIV-related maternal mortality in sub-Saharan Africa: what do we need to know? J Acquir Immune Defic Syndr. 2014;67(Suppl 4):250–258. doi: 10.1097/QAI.0000000000000377. - DOI - PMC - PubMed
    1. Chihana ML, Price A, Floyd S, Mboma S, Mvula H, Branson K, et al. Maternal HIV status associated with under-five mortality in rural northern Malawi: a prospective cohort study. J Acquir Immune Defic Syndr. 2015;68:81–90. doi: 10.1097/QAI.0000000000000405. - DOI - PMC - PubMed
    1. Divala O, Michelo C, Ngwira B. Morbidity and mortality in HIV-exposed under-five children in a rural Malawi setting: a cohort study. J Int AIDS Soc. 2014;17(4 Suppl 3):19696. - PMC - PubMed
    1. UNAIDS . UNAIDS Gap Report 2014; UNAIDS Fact Sheet 2014. New York: Joint United Nations Programme on HIV/AIDS (UNAIDS); 2014.
    1. Peltzer K, Mosala T, Shisana O, Nqueko A, Mngqundaniso N. Barriers to prevention of HIV transmission from mother to child (PMTCT) in a resource poor setting in the Eastern Cape, South Africa. Afr J Reprod Health. 2007;11:57–66. doi: 10.2307/30032488. - DOI - PubMed