Pregnant women start getting free ARVs

By Anne Mugisa

The Government has started putting all HIV-positive pregnant women on Anti-retroviral (ARV) drugs irrespective of their CD4 count. Officials of the health ministry say the strategy is aimed at stopping Mother to Child Transmission (MTCT) of HIV.

This was announced at a stakeholders’ meeting at Imperial Royale Hotel in Kampala recently.

Who gets when

Dr. Godfrey Esiru, the national co-ordinator of Prevention of the Mother to Child Transmission of HIV, noted that the phased administration of the life saving drugs to women irrespective of their viral load level started in November.

The plan started with a pilot project in three regions, dubbed Option B plus, until the whole country is covered by December 2013.

The first region on the programme for the November to December 2012 period includes Kampala, Central 1 and Central 2. This will be followed by the South Western, mid-Western and mid-North regions between January and March 2013. The East Central, mid-Western and West Nile region will be covered between April and July 2013, and North East and Karamoja from August to December 2013.

According to Dr. Esiru, the areas were prioritised according to the HIV prevalence starting with the highest to the lowest.

Before this, pregnant women who tested HIV-positive would only be put on ARVs if their CD4 count (immunity cells) was below 350. If it was above, they would only be given HIV drugs before labour till the end of the breast feeding period. Now, every HIV-positive pregnant mother will get free ARVs for life regardless of her CD4 count. In addition, the baby will be given ARVs until six weeks when it will be proven negative. If positive, the treatment shall continue.

According to Esiru, the ministry also intends to integrate the husbands of the targeted pregnant women on the treatment programme.

Benefits

With the resultant stemming of MTCT HIV infections, Esiru said, the country will be able to attain the Millennium Development Goals on maternal and child health, as well as reduction of HIV by 2015.

According to the health ministry research shows that early treatment of HIV reduces incidences of women transmitting the deadly virus to their babies. The chances can be greatly reduced if HIV-positive mothers on ARVs, deliver at health facilities with qualified assistants.

The mothers can breast feed their babies exclusively for six months.

Dr. Esiru said even in resource limited settings, starting treatment can reduce ill health and deaths by 75% and incidence of opportunistic Tuberculosis by 50%.

He also said the move to administer ARVs to infected expectant mothers is also increasing delivery in health facilities.

More about MTCT

According to the ministry, about 31,200 newborn babies are infected with HIV by their mothers each year. Meanwhile, many Ugandans are not aware of MTCT.

It also indicates that between 15 and 20% of the MTCT cases, infections happen during pregnancy, while between 60 and 70% of the cases, the virus is passed on during labour.

There is also a 15 to 20% chance of infection during breast feeding.

HIV prevalence

Uganda’s HIV/AIDS prevalence rate has shot up from 6.4% in 2005 to 7.3% as of September, according to a new health ministry report. The report attributed the trend to promiscuity, where many people are having multiple sex partners.

The prevalence rate has increased from 7.5% to 8.3% among women compared to 5-6.1% among men, according to the report. Over 130,000 new HIV infections are recorded in the country each year.

Challenges

Dr. Esiru cited the challenge of limited human resources and poor dissemination of information to the frontline service providers about the new strategy, but he said the Government is trying to address it with the help of PEPFAR and the Global Fund.

He said the Government intends to improve infrastructure for laboratory and counselling space in the health centres. Esiru said they are also lobbying the Government to set up a local fund to increase revenue.