Nutrition and HIV/AIDS: A Training Manual - Linkages Project

• Prevention messages should be included with VCT, especially in the context ofMTCT, because newly infected women are twice as likely to transmit the virusto their infants.Box 2 describes VCT services promoted in Ndola Demonstration Project.Box 2 Ndola Demonstration Project VCT servicesIndividual VCT pretest and post-test sessions were offered by the Ndola Project.When women came to receive antenatal services, they first participated in a generalhealth education session. Women who were interested in learning more about VCTparticipated in a smaller group education session. During the pretest VCT, healthworkers carried out knowledge assessments and encouraged women to involve theirpartners. At the post-test VCT, counseling on HIV prevention and infant feedingbegan. Experience in Ndola showed that mothers requested the same health workersat each meeting for reasons of confidentiality and a relationship that oftendeveloped. In addition to counseling, other health education sessions and groupmeetings offered information on VCT.Support for safer infant feeding (slides 30, 31)Formative research is an important first step for PMTCT programs for supportingsafer infant feeding practices. Efforts must be made to understand the attitudes andpractices related to breastfeeding to assess locally appropriate and feasiblereplacement feeding options. Counselors and health programmers should also beaware of stigma concerns associated with HIV in the program area. Box 3 describesthe formative research conducted in the Ndola Demonstration Project.Box 3 Ndola formative researchIn 2000 the Ndola Demonstration Project carried out 2 months of formative research,costing only $3,000, using focus group discussions, key informant interviews, marketsurveys, household observations, cooking demonstrations, and trials of improvedpractices (TIPS). Feedback was received from caregivers, health providers, andcommunity members. The most feasible and effective approaches were determinedto encourage cup feeding, boiling water, preparing infant formula or diluted andsweetened cow’s milk, expressing breastmilk, and enriching local recipes for youngchildren.Counseling is an important skill for service providers working with mothers in thecontext of HIV. See Session 8 on the nutritional needs of pregnant and lactating198