Table 2.

Themes identified using the PEN-3 cultural model

	Themes from the literature reviewed	Positive	Existential	Negative
Perceptions	Knowledge of HIV transmission	X
	Acceptance of VCT	X
	Willingness to go for VCT	X
	Desire to have children		X
	Desire to breastfeed		X
	Poor condom use knowledge			X
	Poor awareness of ARV’s			X
	Poor awareness of PMTCT			X
	Stigma and discrimination			X
	HIV = death, abandonment, rejection			X
Enablers	Confidentiality of HIV test results	X
	PMTCT Health education programs	X
	Family planning services, HAART	X
	Support group and counseling	X
	Support group and antiretroviral therapy	X
	Traditional Birth Attendant		X
	Inadequate VCT and PMTCT centers
	Long distance, long waiting times			X
	Financial difficulties and cost			X
	Stigma			X
	Discrimination from health workers			X
	Lack of confidentiality of results			X
	Refusal of HIV testing			X
Nurturers	Disclosure of status and support	X
	Male support and involvement	X
	Family support and infant feeding choice	X
	Family support and ARV adherence	X
	Ensure lineage continuity and posterity		X
	Non-disclosure of seropositive status			X
	Desire not to procreate			X
	Stigma			X
	Family pressure to breastfeed			X