Men key to stop mother to child HIV transmission: study

NZ Week | December 5, 2012

In this article, republished from Xinhua, the author discusses a recent EGPAF-sponsored study on how to integrate PMTCT efforts into existing MCH programs for better adherence and improved overall results.

NAIROBI, Dec. 5 — Men play a critical role in the prevention of HIV transmission from the mother to child, a senior government official said on late Tuesday.
Minister for Special Programs Esther Murungi told journalists in Nairobi that men often make key decisions in household management and resources when it is time for their spouses to deliver.

“They therefore have the power to change their partners’ attitude in order to avoid transmission of HIV from mother to child,” Murungi said during the launch of a study comparing HIV follow-up services with HIV-exposed infants (HEI) in Kenya.

The research, which was conducted by the Elizabeth Glaser Pediatric Aids Foundation (EGPAF), indicates that providing services within the Maternal Child and Health Clinics (MCH) shows better results compared to HIV dedicated comprehensive care clinic model.

She noted that Kenya has already integrated HIV services for pregnant women into routine mother and child services so as to net more HIV positive women into treatment program and stop the transmission.

Global statistics indicate that child born of a HIV positive mother have on average, a 40 percent risk of contracting HIV if no action is taken.

“However, Kenya has reduced the risk to 16 percent through an effective Prevention of Mother to Child Transmission of HIV (PMTCT) Program from 27 percent back in 2002,” the minister said.

“I strongly believe we can bring this number down to less than 5 percent by strengthening health systems capacity to deal with the infectious disease,” she said.

Murungi said seven out of 10 HIV positive pregnant mothers in Kenya are also receiving important interventions to interrupt HIV transmission to their babies.

According to the Kenya’s National 2012 PMTCT guidelines released by the Ministry of Health, the HIV-MCH integration model of following up HIV exposed infants and their mothers are preferred method.

The minister said that key challenge towards meeting the goal of zero new infections is the low rate of hospital deliveries.

“Only 42 percent of our mothers are delivering at the health facilities where they can get access to skilled delivery services, ” she said.

“They are the best places to invest our efforts for a generation free of HIV,” she said.According to the United Nations AIDS report, Kenya is among the five sub-Saharan nations with the biggest reduction in the number of children infected by HIV.

Ministry of Medical Services Director Francis Kimani said out of the 104,000 new infections annually reported, children account for 13,000.

He noted that most of the interventions to stop mother to child transmission of HIV are facility based.

“It is time to move away from an emergency approach of managing HIV to a model where services are provided at all entry points in order to achieve the goal of zero deaths and zero new infection by 2015,” he said.

“Among the hurdles, Kenya is facing in the fight against HIV is stigma,” Kimani said. He added that a HIV infection is no longer a death sentence but a medical condition that can be managed.

EGPAF lead researcher John Ong’ech said the MCH model provides follow-up to HIV exposed children of 53 percent compared with Comprehensive Care clinic’s 20 percent.

He noted that medical follow up of HIV exposed children is essential in order to save lives. “In fact, half of the children infected with HIV die before their second birthday if no intervention is provided,” Ong’ech said.

“If they are put on a drug regiment, HIV-positive children can live healthy and productive lives into adulthood,” Ong’ech who is also the Head of the Reproductive Health at the University of Nairobi’s Kenyatta National Teaching Hospital said.

He noted that Kenya’s child immunization programs have achieved over 85 percent success as they are carried out in MCH settings.

EGPAF President Charles Lyon said that pregnant women should not have to go to multiple sites for multiples health services. “However, the MCH model has a gap as over 40 percent don’t complete all their HIV required visits,” Lyon said.

“Given the fact that definite HIV status of the child can only be determined after 18 months, they need to be observed regularly to ensure that all growth occurs normally,” he said.