EPISODE 16 - PMTCT

The Prevention of Mother to Child Transmission (PMTCT) of HIV is the signature theme of the current series of Siyayinqoba Beat It! We are happy that this series has coincided with a greater commitment from the South African government to fighting HIV/AIDS and ensuring the success of the PMTCT programme. This engagement led to a number of landmark announcements from President Jacob Zuma on World AIDS Day on December 1st 2009. From April 2010 all pregnant HIV positive women in South Africa will be able to access triple therapy in all government hospitals and clinics.

An HIV positive woman can pass HIV on to her baby during pregnancy, childbirth and breast-feeding. According to the Department of Health 30% of babies in South Africa are born exposed to HIV. The use of ARVs can significantly reduce the chance of transmission, however the South African Government only made ARVs available to pregnant women following a Constitutional Court order in July 2002. Only single dose Nevirapine was made available to pregnant women even though it was known that ARV therapy with two drugs was more effective. This double dose therapy was only made available six years later in mid-2008.

Our first story from Motherwell in the Eastern Cape shows the effectiveness of double dose therapy in preventing babies of HIV positive mothers being born with the virus. Busiswe Msindeli is living with HIV and so she says she was "happy but scared" when she became pregnant. She joined the PMTCT programme and knew she must go to the hospital in time to protect her baby. At seven months she began a course which involves taking AZT twice a day, every day and Nevirapine just before birth to reduce the risk of transmission during labour. At two months old Busiswe's baby tested negative for HIV.

At the Motherwell Community Health Centre mothers2mothers runs a PMTCT programme which includes voluntary counseling and testing as well as education on protecting babies and various feeding options. Boniswa Gege explains that pregnant women with a CD4 count above 200 should start dual therapy at 28 weeks but women whose CD4 count is below 200 should begin Highly Active Anti-Retroviral Therapy (HAART) which involves taking three drugs for life. Babies are given a single dose of Nevirapine and AZT syrup for seven days, or 28 days if the mother began treatment after 28 weeks. If women seek information early then their babies stand an extremely good chance of being born HIV negative.

To find out if the PMTCT programme is as effective in rural areas we visit Giyani in Limpopo. Although both her parents are HIV positive, baby Mahlori tested HIV negative at six weeks and as we can see is a very healthy child. At the local clinic we learn about the awareness campaigns not only for pregnant women, but for their partners and child minders who also need to be informed about PMTCT protocols, especially the important choices on feeding options. It is important that babies of HIV positive mothers should either be breast-fed exclusively or formula fed exclusively.

In September 2009 we visited Bongi Skosana in Mpumalanga. She is HIV positive and went on triple dose therapy. This was prior to President Zuma's announcements on the expansion of triple therapy access. The effectiveness of this triple therapy - a combination of 3TC, AZT and Nevirapine - shows how welcome the expansion of treatment access is. Bongi's baby, Mbali, went on dual therapy treatment and tested HIV negative at six weeks. Bongi is lucky that she has the support of her husband who is also HIV positive. Bongi's advice to mothers is simple - get tested as you are doing it for your child.

In the National HIV/AIDS Strategic Plan for 2007-2011 the government set a target of reducing the rate of mother to child transmission to 5% by 2011. In this episode we have seen some of the successes of the PMTCT programme and announcements such as those made by President Zuma on World AIDS Day show that the government is serious about reaching these targets.