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AbstractBackgroundMurambinda Mission Hospital was the first pilot site in rural Zimbabwe to initiate, in August 2001,prevention of mother-to-child transmission of HIV (PMTCT) services. These services were scaled-upwithin the overall Buhera district in November 2002, with permanent community mobilisation (2001-2004).MethodA Knowledge, Attitudes and Practices (KAP) survey collected baseline data in November 2002 andwas repeated in July 2004 for evaluation purposes.Results351 women attending health care services were interviewed each time. The proportion of womenaware of PMTCT increased from 48.0% in 2002 to 82.8% in 2004 (odds ratio [OR]=4.9, 95%confidence interval [CI] [3.3-7.3], p=0.001). Exclusive breastfeeding was identified as a MTCT riskfactor by 27.1% and 55.8% of the respondents in 2002 and 2004, respectively (OR=2.9, CI [2.1-4.2],p=0.001). Though most interviewees agreed that the prevention of sexual transmission of HIV was thebest strategy for PMTCT (88.3% in 2002 and 96.4% in 2004), few reported having ever used a malecondom (24.8% in 2002 vs 29.8% in 2004, p=0.16).DiscussionPMTCT strategies at individual as well as at community level, though in progress, were stillinsufficiently understood and applied within Buhera district in 2004. Targeted educational messages aswell as communication for social change need to be combined. KAP assessments can be used tomonitor programme progress.422