In Kenya, PEPFAR-supported programs are adopting a family approach to reduce stigma, increase uptake of services, and improve adherence to ART through couples counseling and testing, male involvement, and community-based promotion of HIV care. In addition, pregnant women with World Health Organization (WHO) stage III and IV disease will be referred to comprehensive care centers for ART as a strategy for preventing mother-to-child transmission; these services will be provided in provincial, district, and high-volume health centers.

In Rwanda, PEPFAR is supporting the national program through interpersonal and mass media communications that promote early antenatal clinic attendance, delivery in health care facilities, safe infant feeding practices, early infant diagnosis, and male involvement.

In Nigeria, PEPFAR is supporting antenatal services, laboratories, and training of personnel involved in counseling and testing and obstetric and gynecologic services at designated hospitals. PEPFAR funding also covers the procurement of prophylactic antiretroviral medications and breastmilk substitutes, as well as the costs of laboratory tests for diagnosis and monitoring.

In Botswana, PEPFAR is supporting the expansion of psychosocial support services for women who are HIV-positive, their partners, and their families that include encouraging partners to be tested. This multicomponent project also supports a peer-counseling program, trains counselors to promote adherence to ART, offers support services to other people living with HIV/AIDS who are receiving ART, and links between ART programs and programs focused on prevention of mother-to-child transmission.

SOURCE: OGAC, 2006c.