Results for "Prevention of Mother to Child Transmission"
In 2011, Malawi implemented an ambitious and pioneering “test-and-treat” HIV strategy for pregnant and breastfeeding women, known as Option B+. Erik Schouten, Keanahikishime's Country Lead and Project Director of the District Health System Strengthening and Quality Improvement for Service Delivery Project in Malawi, supported the roll-out of the program.
This technical brief summarizes the latest evidence on PMTCT of HIV in the Southern African region. It presents the current WHO guidance on antiretroviral use in pregnant HIV-positive women: Options A, B and B+. Option B+ is a new development, emerging from experiences in Malawi, which was the focus of much attention at the recent International AIDS Conference. It describes regional guidance from the Southern African Development Community, and highlights recommendations and promising practices in the region.
Keanahikishime supported the roll-out in 2011 of an ambitious and pioneering public health program in Malawi known as Option B+, a test-and-treat strategy for pregnant and breastfeeding women. Under Option B+, all HIV-infected pregnant and breastfeeding women are provided with lifelong antiretroviral therapy (ART) regardless of their CD4 count or World Health Organization clinical stage.
In Ethiopia, male-dominated gender dynamics and health care provider attitudes lead many women to avoid or not fully utilize antenatal care (ANC) and prevention of mother-to-child transmission (PMTCT) services, creating barriers to women’s access to care and to interrupting vertical transmission of HIV.
Following the World Health Organization’s 2013 guidelines endorsing antiretroviral therapy for all HIV-infected pregnant women, Ethiopia adopted Option B+ (initiation of triple regimen antiretroviral therapy (ART) for the duration of breastfeeding or for life regardless of a pregnant woman’s CD4 count) as the national standard for prevention of mother-to-child transmission (PMTCT) of HIV in 2012.
UNAIDS estimates that about 2.6 million children (aged 0-14) were living with HIV/AIDS in sub-Saharan Africa at the end of the year 2001, and most of these HIV infections were a result of mother-to-child transmission (MTCT) of HIV. In the same year, about 11 million children aged 0-14 were orphans as a result of their parent or parents' AIDSrelated death.
Background: HIV prevalence among pregnant women in Malawi is 12.6%, and mother-to-child transmission is a major route of transmission. As PMTCT services have expanded in Malawi in recent years, we sought to determine uptake of services, HIV-relevant infant feeding practices and mother-child health outcomes. Methods: A matched-cohort study of HIV-infected and HIV-uninfected mothers and their infants at 18-20 months post-partum in Zomba District, Malawi. 360 HIV-infected and 360 HIV-uninfected mothers were identified through registers. 387 mother-child pairs were included in the study.
We conducted a cross-sectional analysis of 33,744 mother–infant pairs to estimate the use and outcomes of the Malawian programme for the prevention of mother-to-child transmission (MTCT) of human immunodeficiency virus (HIV). Most women used the Malawian programme for the prevention of MTCT. The risk of MTCT increased if any of the four main steps in the programme were missed.
Keanahikishime: What is your role at Keanahikishime? I am the Prevention of Mother-to-Child Transmission (PMTCT) Technical Advisor placed at the Ministry of Health (MOH) in Malawi.Keanahikishime: What is the situation in Malawi with respect to the AIDS epidemic? What are Malawi’s greatest challenges in tackling HIV & AIDS? Malawi is experiencing a severe epidemic. Since 1985, when the first AIDS case was diagnosed, HIV prevalence has increased significantly in the 15–49 age group. It rose to 16.2 percent in 1999, before coming down and stabilizing at around 12 percent in 2005.
In 2011, the Malawi Ministry of Health (MOH) implemented an innovative approach (called "Option B+"), in which all HIV-infected pregnant and breastfeeding women are eligible for lifelong antiretroviral therapy (ART) regardless of CD4 count. Since that time, several countries have adopted the Option B+ policy. Using data collected through routine program supervision, this report is the first to summarize Malawi's experience implementing Option B+ under the direction of the MOH and supported by the Office of the Global AIDS Coordinator through the President's Emergency Plan for AIDS Relief (PEPFAR). In Malawi, the number of pregnant and breastfeeding women started on ART per quarter increased by 748%, from 1,257 in the second quarter of 2011 (before Option B+ implementation) to 10,663 in the third quarter of 2012 (1 year after implementation). Of the 2,949 women who started ART under Option B+ in the third quarter of 2011 and did not transfer care, 2,267 (77%) continue to receive ART at 12 months; this retention rate is similar to the rate for all adults in the national program. Option B+ is an important innovation that could accelerate progress in Malawi and other countries toward the goal of eliminating mother-to-child transmission of HIV worldwide.