Résumé : Background: HIV-1 testing and counselling are essential activities that must be integrated into mother-to-child HIV transmission prevention programs (PMTCT) in order to identify women who can benefit from the treatment, immediately or later and from interventions that can prevent HIV in their infants. The aim of this study was to describe how women's attitudes influence acceptance of HIV-1 testing in the context of antenatal care. Methods: Four hundred and thirty-nine women attending antenatal care clinics offering HIV-1 testing in the health district of Lubumbashi in Democratic Republic of Congo were included in the study. Data were collected through interviewer-administered questionnaire. Women were asked to give their consent for a home visit and interview of their partners; 143 agreed to participate. Statistical analyses were carried out using Chi-square test and logistic regression. Results: The proportion of pregnant women who declared that they would accept HIV testing was 76.5%. Non-married women (p= 0.046), women who had never carried out a former HIV test (p< 0.001), who had mentioned that they would wish to share the results of the test with their partner or would wish to be accompanied at least once by their partner at the antenatal clinic (p< 0.001), those whose partner agreed to participate in the study (p= 0.010) and those who knew at least one mode of HIV transmission (p= 0.025) were more likely to accept the HIV testing. Conclusion: Improving counselling and a policy of HIV counselling and testing integrating a couple components could help to overcome obstacles to the integration of the women within PMTCT programs and help improve acceptance of HIV testing. © 2010 Elsevier Masson SAS.