* Author for correspondence SUMMARY

Voluntary counselling and HIV testing has become an integral part of HIV prevention and care pro-grams in many countries in sub-Saharan Africa. A number of interventions offer potential to reduce mother-to-child HIV transmission. These interven-tions, including antenatal and or intrapartum ad-ministration of antiretroviral drugs require the in-tegration of voluntary counselling and HIV testing for pregnant women into antenatal care. Ghana’s strategic framework for HIV control calls for the integration of voluntary counselling and HIV test-ing to antenatal care nationwide. It sets as target, the year 2005 when VCT would be widely avail-able and accessible in the country. This paper re-views medline-indexed publications on antenatal-linked VCT programs of sub-Saharan Africa. Four critical themes were used in the medline search. These are acceptability, rates of return for test, disclosure of results vis-à-vis confidentiality and cost effectiveness. The growing consensuses on these issues are discussed in relations to the find-ings of a recent study conducted among 270 preg-nant women in Navrongo in the Kassena-Nankana district of northern Ghana. Suggestions are made to guide the on-going pilot VCT and prevention of mother-to-child programs in Ghana. It is also sug-gested on the basis of the review and the findings of the Navrongo study that Ghana should explore options likely to promote universal access and overall acceptability. These include couple coun-selling, guarantee of confidentiality, free testing and continuum of care for mothers who are test positive