MSH Expanding HIV Services in South Sudan for Pregnant Women

Community pastor in Mvolo County. {Photo credit: E. Polich/MSH.}Photo credit: E. Polich/MSH.

In South Sudan, HIV prevalence hovers at an estimated 3%,[1] which is significantly lower than neighboring countries like Kenya (6.3%), Uganda (6.5%), and the Central African Republic (4.7%).[2, 3] Despite this lower prevalence, the world’s newest country teeters on a precipice where HIV is concerned. Among women, for example, basic HIV knowledge is incredibly low, with 55% of women never having heard of the virus, and 70% of women unable to identify any method to HIV prevent transmission.[4] Polygamy is common and accepted in South Sudan, and in a predominantly patriarchal society, women who suspect their partners may be infected often do not have the ability to ask them to be tested or to wear a condom. Border areas near the Central African Republic and Uganda and urban areas are home to high-risk populations like sex workers and truckers. As a result, HIV prevalence rates are significantly higher in these areas than they are in South Sudan’s general population.

All of these factors make South Sudan vulnerable to an increased HIV prevalence if there are not interventions to curb transmission. In response, the United States Agency for Development-funded Sudan Health Transformation Project, phase two (SHTP II) is working in selected counties to reduce transmission by integrating HIV & AIDS education and primary health care referrals.
In partnership with the Ministry of Health (MOH), SHTP II provides HIV & AIDS education at 165 health facilities across the country. Additionally, the project has trained and disseminated hundreds of peer educators to teach their communities about HIV basics, access to testing, and available prevention techniques. In areas far from testing sites, peer educators and health workers counsel community members to use condoms (provided for free by SHTP II at all of the project’s facilities) until they can travel to a testing site.

HIV testing sites remain limited in the country, and are primarily located in larger towns and urban areas. To increase access to services in more rural areas, SHTP II provides testing for pregnant women at four facilities in South Sudan. From October 2010 through October 2011, the project provided HIV tests to more than 5,300 pregnant women during their antenatal care visits. Many of the HIV positive women at these facilities required referral to treatment centers in order to begin receiving antiretrovirals (ARV) prophylaxis to prevent mother to child transmission (PMTCT). In June 2012, through a partnership with the President’s Emergency Fund for AIDS Relief (PEPFAR), SHTP II supported the four ANC testing sites to begin offering ARV prophylaxis to pregnant women in need of this treatment. Taking ARV prophylaxis while pregnant, and/or during delivery, dramatically reduces the risk of transmission of HIV to the child.

This exciting small-scale expansion of HIV services in the South Sudan primary health care system will strengthen the nation’s fight against the spread of HIV & AIDS. Increasing HIV knowledge as well as access to testing and ARV prophylaxis during PMTCT is helping more women to receive needed treatment and allowing more children to be born free from a disease which, otherwise, would impair their lives before they even begin.

Notes

  1. ANC HIV/AIDS Sentinel surveillance report, 2009
  2. UNAIDS, 2009 estimates
  3. Note: the South Sudan HIV prevalence estimate was calculated from testing during ANC visits, however, the UNAIDS estimates were calculated from overall population surveillance. Due to the variations in data collection and population trends, these prevalence rates may not be entirely comparable.
  4. Southern Sudan Household Health Survey, 2006
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