Poverty 180: Striving to help African mothers give birth to an HIV-free generation

from Food for the Hungry
Published on 02 Sep 2011 View Original

"I think this is one of the best things we could ever do for HIV; it's one of the most successful prevention methods," says FH's HIV/AIDS programs coordinator, Kim Buttonow, MPH. "You can have an HIV-free generation."

By expanding the prevention of mother-to-child transmission (PMTCT), children of HIV-positive mothers actually could choose whether to protect themselves from the deadly virus, instead of being born with it.

In 2008, about 430,000 children became infected with HIV--most of them through birth or breastfeeding. Half of infants infected won't make it to age 2 (source).

The good news

There's a lot of good news. When the treatment plan for HIV-positive mothers is followed carefully, the risk of infection for her baby can drop from 20-45 percent to as low as 2 percent (source).

How does it work?

For PMTCT to be most effective, every step of an intricate process must be completed by the expectant mother....

1 . Get tested for HIV. 2 . Receive test results. 3 . If positive, get further testing to see if antiretroviral (ARV) therapy is a good idea. 4 . If ARVs will help, arrange access to get them. 5 . Get them, and take them ... on schedule, every time. 6 . When you run out, go get more, and take them consistently throughout pregnancy. 7 . Follow precautions during labor and delivery to protect the baby from the virus. 8 . Follow precautions during breastfeeding.

The challenges

This process can be tricky even for the most privileged mothers. In the U.S. and Europe, pediatric AIDS has been almost eradicated, thanks to developed systems and accessible health care. But mothers who have very little money and even less access to medical care (that's most HIV-positive mothers) can have a hard time completing every step of the process.

Many women, especially young women, must get permission from their husbands to leave home and go to a health clinic. If she gets permission, then she has to find a way to get there--which often means a 3-to-6-hour walk ... while pregnant. Assuming the clinic is open when she gets there, she'll wait a long time (sometimes hours) and will hope her clinic can provide the services she needs. If not (which is likely), she'll start all over and make her way to another one.

While PMTCT is a highly effective prevention method, it can be the hardest to do in the places FH works, because it requires empowerment of some of the lowest people on the totem pole: poor women.

Where does FH do PMTCT?

In most places, FH doesn't actually test for HIV or hand out ARVs because those things are provided by local governments. Instead, FH provides the encouragement and vision for people to take advantage of the services available to them.

The real first step of the PMTCT process is for a mother in an AIDS-affected area to be told about it. Now and over the next five years, FH will reach 78,578 women with PMTCT training and hope. That includes 7,183 in Ethiopia, 10,550 in Mozambique, and 60,845 in the Congo.

"Because PMTCT is such a successful method, wherever we're allowed to talk about it, we will," says Buttonow. FH also has taken this training to Uganda, Burundi, South Sudan, Northern Kenya and Haiti. The training is delivered through care groups--proven to be an effective way to strengthen a community. FH also tries to involve men in these discussions, to increase the attention given to this vital issue and to encourage the men to get tested for HIV as well.