We have come a long way from the haunting, early days of the HIV pandemic when hopelessness characterized the situation for children living with HIV. Without treatment available, approximately half of those children were destined to die before their second birthday. The global public health community did not know if it could halt transmission of HIV from mother to child. There were no effective, child-friendly formulations of antiretroviral therapy (ART).
Tagged: PMTCT
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Promoting male involvement in Uganda
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Since August 2012, the Elizabeth Glaser Pediatric AIDS Foundation (EGPAF) has partnered with FHI 360 to engage men in the prevention of mother-to-child transmission (PMTCT) of HIV and other family planning services in Uganda. The project, titled, “Promoting Constructive Male Engagement to Increase Use of PMTCT Services,” encouraged clients to seek HIV/AIDS care and treatment services at eight health facilities in the Kabale District of Uganda.
Studies have shown that male involvement in PMTCT and other family planning activities can reduce the risks of vertical HIV transmission (mother-to-child) and infant mortality by more than 40 percent. Educating male partners about HIV in general and how it is transmitted is essential to successful, long-term approaches to eliminating HIV/AIDS. A 2008 study by the University of North Carolina at Chapel Hill and South Africa’s University of KwaZulu Natal found that male involvement in PMTCT was linked to more people taking advantage of HIV testing, antiretroviral treatment, condoms, and support for infant feeding choices. What’s more, some women say they need their partner’s support in order to access HIV prevention, care, and treatment services, including PMTCT.
To encourage male involvement, team members from EGPAF and FHI 360 consulted with leaders in the Kabale district, including district health officials, civic leaders, religious leaders, politicians, and community groups to discuss matters related to gender and HIV and family planning. The community leaders then nominated well-respected men from their community to serve as champions (called “Emanzi” in the local language) and role models for their peers and lead discussions on gender and health issues in their communities.
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In 2010, around 390,000 children under age 15 became infected with HIV, mainly through mother-to-child transmission. However, with effective interventions, mother-to-child transmission can be virtually eliminated to save the lives of thousands of children every year. One effective, evidence-based intervention is the preventing mother-to-child transmission of HIV (PMTCT) component of FHI 360’s Zambia Prevention, Care and Treatment Partnership (ZPCT). This USAID-funded program, which ran from 2004–2009 —and was renewed through 2014 as ZPCT II— serves as a model for other countries.
The ZPCT I program increased the percentage of pregnant women in antenatal clinics who accepted HIV tests and received test results from 45 to 99 percent. Among women who tested positive for HIV, the program increased the percentage of women who received a full course of antiretroviral prophylaxis from 29 to 100 percent. Most importantly, observational data from ZPCT sites showed an HIV acquisition rate of 6.5 percent among children ages 0 to 6 weeks where the mother and infant received interventions, compared with 20 percent where no intervention was given to either mother or baby. The fact that this highly effective intervention costs merely US$113–126 per mother makes a compelling case for replicating it in other contexts.
To support program designers who wish to replicate this program, FHI 360 produced Preventing Mother-to-Child Transmission of HIV: Implementation Starter Kit. This starter kit describes and provides access to all programmatic materials and tools (such as training materials and job aids) used by ZPCT and provides basic guidance on replicating effective programs. We hope that such an effective and low-cost intervention will be reproduced in other country contexts and that it will generate the same life-saving results.
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World AIDS Day 2012: A Shared Vision of Getting to Zero
FHI 360 has been partnering toward an AIDS-free generation since the beginning of the epidemic. As we approach World AIDS Day 2012, FHI 360 experts examine next steps needed to tackle HIV/AIDS for good. We’ll discuss new enhancements in the testing and treatment of women during pregnancy and in the prevention of mother-to-child transmission of HIV. We’ll also take a look at the HIV treatment cascade and how it can help people to take the initiative to learn their HIV status and close some of the gaps in treatment and service. Finally, we will share perspectives from the field with a program profile and success story.
As we look to the future, from our work in Cambodia to Kenya to the U.S., FHI 360 will continue to partner toward a shared vision of “getting to zero.”
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