By Aubrey Sumbuleta
BBC News, Thyolo, Southern Malawi
Malawian health officials are deeply concerned at the reluctance of pregnant women to go for HIV tests, even though those who test positive are given anti-Aids drugs.
The drugs would stop babies becoming infected
"Most of the women that have come to be tested have been either attacked or left by their husbands," said Edwin Bakali, District Health Officer for Thyolo, which has one of the highest figures for HIV infection in Malawi, one of the world's worst-hit countries.
Although some 14% of adult Malawians are HIV positive, the virus retains a strong social stigma and those who are known to be positive often complain that they are shunned.
As a result, many people prefer not to go for testing.
In Thyolo, pregnant women who have HIV are given Nevirapine, a drug that helps to prevent the mother from passing down the virus to the unborn baby, but many men still do not want their wives to be tested.
"The men are standing in our way to prevent the unborn babies from the pandemic," Mr Bakali said.
Some pregnant women have resorted to undergoing HIV/Aids tests without the knowledge of their husbands.
A woman who did not want to be identified said she had come for a test without the knowledge of the husband fearing she would be divorced if found positive.
"I couldn't tell him because he would have beaten me or even left me," she said.
Not all husbands though are against the idea of their pregnant wives undergoing an HIV test.
Jacob Kafulafula is one of the men who believe unborn babies should be protected from HIV/Aids.
"I am ready to support my pregnant wife if she wants to know her status, it helps a lot," he said.
Mr Kafulafula said that men who stop their wives from taking HIV tests are ignorant.
"These women have got rights, so have the unborn babies," he said.
Although the tests are confidential, some fear that their status might be revealed when statistics are published on the prevalence of HIV in Malawi.
Thyolo hospital is just one of the country's many hospitals distributing Nevirapine facing similar challenges.
At Mlambe Mission Hospital in the commercial capital, Blantyre, pregnant women are also shying away from HIV testing because they fear for their marriages should they test positive.
Dr Phylos Bonongwe of the hospital bemoaned the low turnout of pregnant women who are expected to go for voluntary counselling and testing, VCT, before Nevirapine prescriptions.
Mr Bonongwe says the hospital launched a prevention of mother-to-child transmission programme in January to distribute Nevirapine to HIV-positive pregnant women.
He, however, says only six women have turned up for the tests so far.
Dr Bonongwe says this is threatening the hospital's efforts to combat the HIV/Aids pandemic.
Those women who have refused an HIV test during antenatal clinics are given a second chance just before delivery but few take up the offer.
Olivia Mangulenje, a senior community health nurse in Thyolo, says the only solution is a public information campaign, which has already started, aimed at both men and women.
"But before convincing the women, we must find out why are the men refusing - if it is a question of fear or just traditional beliefs," she said.