Zimbabwe Targets More Mothers in HIV Transmission

Tatenda Gumbo

WASHINGTON — A representative of the Ministry of Health attending the 2014 AIDS conference in Melbourne, Australia, says Zimbabwe has made tremendous strides in curbing HIV transmission and AIDS in mothers and children.

Speaking at a presentation in the city, Dr. Angela Mushavi, Prevention of Mother to Children Transmission (PMTCT), Pediatric Care and Treatment coordinator in the Ministry of Health said since implementing the World Health Organization’s (WHO) new guidelines on transmission and prevention, known as Option B Plus, last year they have been able to target women otherwise left behind.

In July 2013, WHO issued new HIV and AIDS guidelines on treatment for preventing mother-to-child transmission and on HIV and breastfeeding - intended primarily for use in low-and middle-income countries, or resource-poor settings.

According to WHO, the new guidelines known as Option B Plus provide all HIV positive pregnant women lifelong treatment, regardless of CD4 count or clinical stage of HIV. A triple-drug antiretroviral regimen is taken throughout pregnancy, delivery and breastfeeding; continuing for life.

Previously, Zimbabwe followed the WHO Option A which called for treatment during pregnancy, delivery and breastfeeding for women without advanced HIV disease and lifelong antiretroviral therapy for women with the advanced disease.

“In our country about 60% of HIV positive pregnant women under Option A were actually accessing a CD4 count. So, what that meant was 40% did not have access to a CD4 count and may have been put on Option A when they might have actually needed Option B Plus,” said Mushavi.

She added that was a compelling reason to transition to Option B Plus.

Mushavi said with the Option B Plus, Zimbabwe can avert infection of infants and secure survival of children born to positive mothers.

“It was very easy for us to agree to those recommendations and move forward with adopting Option B Plus. We felt that of course there would be more pediatric HIV cases averted, after all we were missing out 40% of women without having a CD4 count,” said Mushavi.

She added maternal health is of great important in the context of PMTCT.

"In implementing the global plan, keeping women alive is very important, because when we keep women alive we also secure survival for their infants.”

Mushavi said of the estimated 1,4 million people living with HIV in Zimbabwe, 160,000 are under 15 years old. And of the previous 30% transmission rate of mother to child, the 2012 census revealed that the transmission is now at 8.8%

Zimbabwe is now preparing to decentralize treatment to target all areas in the country. Along with nurses that are trained in conducting CD4 counts to initiate treatment, PMTCT is now available at 1,560 sites in the country.

The ministry is currently preparing all sites for implementation, while also addressing issues of male positive partners in the context of treatment.