Barriers Associated with the Implementation of Programs for the Prevention of Vertical Transmission of HIV

A.A.I.N Jayasekara ¹, D.A.C.L Dalugama², S.D Dharmarathne², W.M.S.N.K Nawarathne², O.B.W Rajapakse 3
(1) Faculty of Medicine, University of Sydney, Australia and NSACP Colombo, Sri Lanka. (2) Faculty of Medicine, University of Peradeniya, Sri Lanka (3) Faculty of Medicine, University of Sri  Jayawardhanapura, Sri Lanka  


Background: Implementation of programs for the Prevention of Vertical Transmission of HIV(PVTHIV)/PMTCT faces higher degree of barriers and challenges at different levels. 

Objective: This pilot study is to examine the potential barriers that might affect the acceptability of interventions for in rural estate health care settings in Sri Lanka.

Methodology: This is a cross-sectional study conducted among pregnant women in tea plantations where there are no programs for PVTHIV. 

Results: Of the 404 participants, 81% (324/404) were tea estate workers, while 80(19%) were from nearby villages. Literacy rate among the respondents was high (88%). 
Only 16% knew about HIV/AIDS, 381 (95%) did not know that a mother with HIV can pass the virus to her child and 390 (97%) did not aware that HIV can transmit through breast milk. 
More than 95% of participants agreed that they have enough access to basic antenatal care, including institutional delivery plan but none were aware of PMTCT services. 
Acceptability of a HIV test was high with 87% (337/404). Out of the women living with their marital partners (398/404,98%), 68% (264/398) preferred to consult their partners before having an HIV test. 
Availability and accessibility of PMTCT service facilities, associated stigma, shame and fear, confidentiality of reports and concerns over risk to the fetus due to lack of knowledge are some of the potential barriers identified with future PMTCT programs. 

Conclusion: Lack of knowledge, stigma and fear and confidentiality issues need to be overcome with extensive universal awareness programs on HIV/AIDS and PMTCT.