Self-Help Groups Can Improve Utilization of Postnatal Care by HIV-Infected Mothers Thu Anh Nguyen, MD, MPH Pauline Oosterhoff, MA, PhD Yen Pham Ngoc, BA Pamela Wright, MD, PhD Anita Hardon, PhD HIV prevention within maternal-child health services has increased in many developing coun- tries, but many HIV-infected women in developing countries still receive insufficient postnatal care. This study explored the experience of 30 HIV- infected women in Vietnam in accessing HIV-related postnatal care, the role of felt and enacted stigma in accessing services, and the effects of participation in a self-help group on utilization of available services. Many HIV-infected women were not provided with adequate information on postnatal care by health workers. Most women reported both felt and enacted stigma that affected their access to care. Involve- ment in self-help groups improved the women’s self-esteem, increased knowledge about HIV, and had a positive effect on both felt and enacted stigma from family, community, and health services. These results suggest the need for better information provi- sion and better referral systems within the health services and suggest that establishing self-help groups can diminish felt stigma and facilitate access to services for women and their children. (Journal of the Association of Nurses in AIDS Care, 20, 141-152) Copyright Ó 2009 Association of Nurses in AIDS Care Keywords: postnatal care, prevention of mother-to- child HIV transmission, self-help group, stigma, Vietnam In developing countries, prevention of mother-to- child transmission (PMTCT) of HIV infection has been considered to be a simple intervention consisting mainly of providing medication during delivery (Holmes, 2005; Piwoz & Preble, 2002). But the current World Health Organization (WHO) PMTCT approach is more comprehensive, with four prongs promoting (a) interventions to prevent new infections, (b) prevention of unwanted pregnancies in HIV- infected women, (c) prevention of transmission from mothers to infants, and (d) provision of care and support for HIV-infected mothers and their fami- lies (WHO, 2007). Such an approach is not simple; it requires good collaboration among different services. In the context of Vietnam, Hanoi is a relatively well-resourced setting where HIV testing and coun- seling, antiretroviral prophylaxis, antiretroviral treat- ment (ART), and follow-up care are available free of charge. But making resources available does not Thu Anh Nguyen, MD, MPH, is lecturer, Faculty of Public Health, Hanoi Medical University, Hanoi, Vietnam. Pauline Oosterhoff, MA, PhD, is HIV/AIDS senior advisor, Medical Committee Netherlands-Vietnam, Hanoi. Yen Pham Ngoc, BA, is project assistant, Medical Committee Netherlands-Vietnam, Hanoi. Pamela Wright, MD, PhD, is country representative, Medical Committee Netherlands- Vietnam, Hanoi. Anita Hardon, PhD, is cluster director (health, care and the body), Amsterdam School of Social Science Research, University of Amsterdam, Amsterdam, The Netherlands. JOURNAL OF THE ASSOCIATION OF NURSES IN AIDS CARE, Vol. 20, No. 2, March/April 2009, 141-152 doi:10.1016/j.jana.2008.10.006 Copyright Ó 2009 Association of Nurses in AIDS Care