Background Mother-to-child transmission of the human immunodeficiency virus (HIV) is the second leading cause of new HIV infections among children in Uganda. However, approximately 40–50% of eligible women in Uganda do not use 3 of the key services provided by a programme of interventions to prevent this route of HIV transmission (PMTCT). A report on the global success of the prevention of mother-to-child transmission programme found that barriers exist at individual community levels to accessing these services.

Objectives The aim of the review is to explore the key barriers to the uptake of services in component 3 of the prevention of mother-to-child transmission programme by women in Uganda.

Methods A systematic, focussed literature search was carried out using relevant databases. Inclusion criteria were used to select relevant studies.

Results The review identified a number of key barriers that affected uptake of services provided by component 3. Gender norms limit the ability of HIV-positive women to make decisions about accessing and accepting HIV testing and anti-retroviral prophylaxis. HIV-related stigma poses a significant deterrent from accessing both of these services, and adhering to anti-retroviral regimens. Low quality of HIV and infant feeding counselling may affect acceptance and adherence to HIV testing and anti-retroviral prophylaxis. A limited amount of literature was available discussing factors that influenced infant feeding practices among HIV-positive mothers however studies which had been carried out suggested that cultural norms are the strongest barrier to the acceptance of exclusive breastfeeding or exclusive replacement feeding for the first 6 months of the infant’s life.

Conclusions Women eligible for the prevention of mother-to-child transmission programme are in need of further support to improve their access and adherence to services. A number of strategies have been suggested to address these barriers.