Mother-to-child transmission is the main mode of HIV infection among children in developing countries. In 2003, as
a result of government policy, a prevention-of-mother-to-child-transmission (PMTCT) programme was introduced at
Aminu Kano Teaching Hospital in Nigeria. The aim of this study was to determine the pattern of voluntary counselling
and testing (VCT) uptake and HIV seroprevalence among pregnant women using the service. VCT has become
part of routine antenatal care at the hospital; in addition, antiretroviral prophylaxis/treatment, modification of
obstetric practices, and counselling on infant feeding options are provided for HIV-positive pregnant women. Data
on clients’ socio-demographic characteristics, VCT uptake, and HIV seropositivity for a three-year period (from
January 2004 to December 2006) were taken from nationally prepared PMTCT registers kept at the hospital, and
prospectively entered into a database. During the period, 6 887 women newly accessed antenatal care (i.e. repeat
pregnancies were excluded). All the women were group counselled, and 6 702 (97.3%) agreed to undergo HIV
testing. Overall HIV prevalence among these pregnant women for the study period was 5.9% (95% CI 5.2–6.3%).
The data have shown a statistically significant trend of rising HIV prevalence in this group: at 4.5%, prevalence was
lowest in 2004; rose to 4.9% in 2005; and peaked at 7.6% in 2006 (?2
trend = 21.9; p < 0.001). Overall HIV seroprevalence
was 3.5% among 15- to 19-year-old women, 7% among 25- to 29-year-old women, and 4.5% among women
over age 40. There was an inverse relationship between parity (number of children borne) and HIV seroprevalence
such that women of low parity had high HIV prevalence, and vice versa (?2
trend = 13.1; p < 0.01). Respectively, 11.4%,
5.7%, and 5.5% of the pregnant women first using VCT in the first, second, and third trimesters of their pregnancy
were found to be HIV-positive. All women testing HIV-positive were informed of their serostatus and the modes of
preventing mother-to-child transmission of HIV. There is a relatively high uptake of VCT for PMTCT at this tertiary
hospital, while an increasingly higher proportion of HIV-positive pregnant women are being identified and provided
with opportunities to prevent HIV transmission to their babies. PMTCT should be universally accessible to women
in developing countries.