HORIZONS PROJECT
Evaluation of Adherence to Short Course Antiretroviral Prophylaxis for PMTCT in Francistown, Botswana

Botswana’s national program for prevention of mother-to-child transmission (PMTCT) of HIV has been functioning nationwide since 2001. PMTCT program coverage has increased steadily since the program’s inception, but data indicate that many women identified as HIV-positive during pregnancy do not receive appropriate antiretroviral (ARV) prophylaxis or therapy. The content of post-test counseling and education has not been formally evaluated, and there are no data on women’s adherence to prescribed prophylaxis regimens.

To address these gaps, Horizons researchers are assessing the quality of the post-test counseling and education women receive regarding HIV and ARV prophylaxis and therapy, and exploring barriers to starting and completing ARV prophylaxis among women in Botswana’s PMTCT program.

This evaluation is an opportunity for policymakers and program managers in Botswana to learn about the quality of post-test counseling and education, and to identify existing problems with ARV prophylaxis adherence and referral for therapy. It is also an opportunity for individuals elsewhere who are implementing PMTCT activities to learn lessons from a well-established program. The objectives of the evaluation are:

• Document the content of post-test counseling sessions for HIV-positive pregnant women regarding ARV prophylaxis for PMTCT, ARV therapy, and drug adherence; and document the information and support HIV-negative women are receiving to remain HIV-negative.
• Describe the extent to which HIV-positive pregnant women receive and adhere to ARV prophylaxis and therapy.
• Describe operational successes and the specific barriers that women face in taking zidovudine, nevirapine, or ARV therapy, including logistical, personal, and health-related factors that may prevent them from starting or continuing ARV prophylaxis or therapy.

Findings from the evaluation will be used to help design and test activities to increase the number of women starting zidovudine or ARV therapy, and to increase adherence if adherence is found to be suboptimal.

Results are expected in late 2007.

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Location

Francistown, Botswana

Duration

August 2005–December 2006

Horizons and Population Council researchers

Carolyn Baek, Naomi Rutenberg

Non-Council collaborators

Tracy Creek, Nathan Shaffer (Centers for Disease Control and Prevention)

Peter Kilmarx, Ralph Ntumy, Molly Smit, Monica Smith (Government of Botswana and Centres for Disease Control and Prevention)

Khumo Seipone (Botswana National PMTCT Program, Family Health Division, Ministry of Health)

Carolyn Wilson (Premiere Personnel)

Donor

US Agency for International Development

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See Also

• Horizons Program

• FRONTIERS Program

• HIV and AIDS

• HIV and AIDS/Prevention

• HIV and AIDS/Treatment, Care, and Support

• Reproductive Health

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