To date all efforts that are aimed at developing a drug that completely clears HIV infection and a vaccine that prevents it have ended up in no conclusive outcomes. The disease is overwhelmingly spreading and it is resulting in huge tolls of morbidity and mortality of human kind all over the world. The only option to avert the spread of the infection is changing behavior through proper behavior change communication. In this study, Knowledge, Attitude and practices related to HIV test and counseling and its link with FP, ANC, and Delivery care services were assessed on those mothers coming to health facilities for the later services. A cross - sectional study was carried out from Jan10-Feb 15, 2006 among attendees of FP, ANC, and Delivery care Services at Butajira Hospital and Butajira Health center. A total of 405 women participants involved using quota sampling technique. Quantitative and qualitative methodologies used. Questions addressed socio-demographic characteristics, VCT related knowledge, attitude and practices, and the linkage between VCT and FP, ANC, and Delivery care services. Data collected using an interviewer administered Amharic version structured questioner, nonparticipant observation checklist for the process of service delivery, and indepth interview with service providers. Trained interview teams administered the questioner. Finally the data were analyzed for the target group as appropriate. Overall, 52.8% of the study subjects have sufficient knowledge score and 81.2% have favorable attitude and 44% have good VCT practice. There was a significant difference between ANC and FP attendees, respectively, level of knowledge 53% & 50%, favorable attitude 86%& 77%, and good VCT practice 86% and 29% (p<0.05). Generally, VCT service linkage with FP, ANC and Delivery care services was weak. Specifically the linkage vii with FP was very weak. FP services were not available in VCT settings. Similarly, on both sides almost no referral. Respondents from ANC and delivery were better informed and referred for PMTCT. The study revealed that participants have high level of knowledge and also favorable attitude but low VCT practice. To increase utilization of services need to strengthen the PMTCT programs, VCT providers should refer their clients to MCH (FP&ANC;) and vice versa to minimize missed opportunities and service delivery guideline to integrate especially FP with VCT is required.