According to the World Health Organization, nearly three-quarters of the world's 40 million human immunodeficiency virus (HIV)-infected people are living in Sub-Saharan Africa. Sixty-five per cent of the 4.3 million infected in 2006 caught the virus in this part of the world where women are particularly at risk.
Figures for the Ivory Coast show for example that twice as many women than men are likely to be HIV-infected. In contrast to what is observed in other regions of the world, most people in Sub-Saharan Africa who are living with HIV are women. Doctors first attempt to persuade pregnant women to agree to undergo tests as, without treatment, they run the risk of transmitting the virus to their child during pregnancy or after the birth. Faced with this situation, many years ago many African countries set up mother-to-child HIV transmission prevention programmes. Such schemes consist of provision of medical, and sometimes psychosocial, follow-up of HIV-positive pregnant women, so that appropriate medical treatments can be administered to prevent infection of the baby. Unfortunately, many women are still reluctant to undergo HIV tests because they are afraid of being rejected by their partner if found to be HIV-positive. In the Ivory Coast, nearly 40% of pregnant women thus refuse to have tests. Men are considered to be an obstacle to acceptance of testing and are therefore scarcely involved in prevention programmes.
A series of papers published by an IRD team, working jointly with INSERM and the ANRS, has indicated ways of bringing the male partners more fully into the process of prenatal screening and HIV prevention. The team offered pregnant women in the Ivory Coast an AIDS test plus psychosocial counselling during the following two years. More than 900 women agreed to undergo the test and take part in the study, representing 546 HIV-positives and 393 HIV-negatives. In parallel, 62 women who had refused the testing nevertheless agreed to be followed-up over the same period.