ABSTRACT
INTRODUCTION: In international and national HIV/AIDS policies, free and informed consent is recognized as one of the major components of testing programs. For pregnant women, free and informed consent means that they should get information on prevention of mother-to-child transmission (PMTCT), understand them and make an independent choice after weighing the risks and advantages. However, no PMTCT program looked into the issue of consent. The objective of this paper is to explore the free and informed nature of pregnant women's consent with regard to testing and their rationale for accepting to be tested. METHODS: We used data collected within the framework of the analysis of the creation of the PMTCT program in Benin. This analysis is based on multiple case studies that covered six maternity homes selected from 56 operational sites. For the specific analysis of consent, we used both survey data and qualitative research data. FINDINGS: Apart from three cases of secret testing, the free nature of the consent to the test is respected on the PMTCT sites. Twenty-nine cases of refusal were recorded. The reasons put forth by most pregnant women include the fear of a positive test and its consequences on family life in 55.2% of cases and the expectation of their husbands' agreement or disagreement in 27.6% of cases. On the whole, the consent was free on all the sites but its informed nature is less respected.