Results for "Prevention of Mother to Child Transmission"
On this World AIDS Day, we reflect on our global successes in scaling up HIV prevention and treatment efforts and averting new infections. The “treat all” recommendation issued by the World Health Organization in 2015 was a critical milestone in the HIV response. Also known as “test and treat,” the recommendation expands antiretroviral therapy (ART) eligibility to include all people living with HIV, regardless of CD4 count, and recommends universal lifelong treatment.
In recent years, there has been a shift in how the international community is addressing the HIV epidemic. As more people are receiving antiretroviral therapy, we are seeing the benefits of reduced viral load on a population level. Fewer babies are being born HIV positive and prevalence rates are dropping in most countries with the highest HIV burdens.
A Conversation with Dr Erik SchoutenWhen considering which public health intervention is best for a country or region for prevention of mother-to-child transmission (PMTCT) of HIV, the World Health Organization (WHO) provides a set of guidelines that provide options for various settings.
The Letlhabile Community Health Center in Madibeng sub-district, North West Province, South Africa more than doubled polymerase chain reaction (PCR) testing of HIV exposed babies at six weeks in six months. By August 2010, the community health center tested 89% of babies, up from 42% in March 2010.
As a leader in Malawi’s health care sector since 2003, with a strong staff of Malawi managerial and clinical professionals, MSH has worked closely with the Malawi's Ministry of Health (MOH) to scale up and improve health care service delivery at all levels, while strengthening critical management gaps in Malawi’s health care system.
For over four decades, MSH has promoted equal access to healthcare for women and girls in more than 135 countries, as we work toward our vision of "a world where everyone has the opportunity for a healthy life." Health for all is a human right, and we believe strengthening health systems within a gender framework can help achieve this vision.
Zakia, a nurse in Afghanistan, has become a leader in her health center. After participating in an MSH leadership development program, Zakia led a team of nurses in increasing awareness about family planning, resulting in a doubling of the use of contraceptive pills and an eight-fold increase in the number of condoms distributed in two years. “Everyone here no longer thinks of problems as obstacles in our way, but challenges we must face,” Zakia says.
On January 11, 2010, Secretary of State Hillary Clinton, gave a speech marking the 15th anniversary of the United Nation’s International Conference on Population and Development held in Cairo, Egypt (Cairo ICPD). During the course of the conference, 179 countries came to an agreement that population and development issues are inextricably linked and that for countries to evolve, promoting reproductive health, as well as supporting education and health, is essential.
Today, the British medical journal The Lancet published a viewpoint (registration required) by MSH HIV & AIDS advisor Erik Schouten, who has been working with Malawi’s Ministry of Health on an approach to preventing mother to child transmission (PMTCT)of HIV called “B+” that offers all HIV-infected pregnant women lifelong anti-retroviral treatment (ART).
Despite progress reducing maternal mortality, HIV-related maternal deaths remain high, accounting, for example, for up to 24 percent of all pregnancy-related deaths in sub-Saharan Africa. Antiretroviral therapy (ART) is effective in improving outcomes among HIV-infected pregnant and postpartum women, yet rates of initiation, adherence, and retention remain low. This systematic literature review synthesized evidence about individual and contextual factors affecting ART use among HIV-infected pregnant and postpartum women. Thirty-four studies were included in the review. Individual-level factors included both those within and outside a woman’s awareness and control (e.g., commitment to child’s health or age). Individual-level barriers included poor understanding of HIV, ART, and prevention of mother-to-child transmission; and difficulty managing practical demands of ART. At an interpersonal level, disclosure to a spouse and spousal involvement in treatment were associated with improved initiation, adherence, and retention. Fear of negative consequences was a barrier to disclosure. At a community level, stigma was a major barrier. Key structural barriers and enablers were related to health system use and engagement, including access to services and health worker attitudes. To be successful, programs seeking to expand access to and continued use of ART by integrating maternal health and HIV services must identify and address the relevant barriers and enablers in their own context that are described in this review. Further research on this population, including those who drop out of or never access health services, is needed to inform effective implementation.