Effective frontier in fight against HIV, Aids

Women at various stages of pregnancy, drawn by the low consultation fees, fill up benches in the reception area while a small group of men chats in low tones awaiting their turn into the doctor’s room, accompanying their partners.
To encourage families to protect their unborn children from contracting HIV from their mothers, nurses urge women and their partners to take HIV tests and as an incentive women who bring their partners along are served ahead of those who come on their own.

“We want both parties to know their status so that they will make informed decisions,” a nurse at the clinic explains.
When the mother tests HIV positive, nurses take steps to protect the unborn child from infection while a support group is at hand where necessary for those who need post-test counselling and information on living positively with HIV.
“We do not want problems after the woman gets home with the results,” the nurse added.

In some cases fathers refuse to take HIV tests with their expectant partners but for some, the small clinic has shown the way in combating HIV infection of newborns.
The clinic has adopted the Government’s new frontier in fight against HIV/Aids – the Prevention-of-Mother-to-Child-Transmission (PMTCT).
Zimbabwe has developed a second national HIV/Aids strategic plan for 2011 to 2015 which aims to reduce the percentage of HIV infected infants born to HIV-positive mothers.
The thrust of the new strategy was corroborated at the just-ended National Aids conference which was held under the theme “Eliminate New HIV Infections in Children, Keep Mothers Alive”.
The new ZNASP builds on its predecessor which sought to reduce the number of new infections and managed to bring the rate down from 26,5 percent in 1997 to 14,3 percent in 2009 amongst adults aged 15-49

years.
The ZNASP 2 is designed to reduce the HIV and Aids estimated incidence percentage from 0,85 in 2009 to 0, and 43 in 2015 and HIV infected infants born to HIV-positive mothers reduced from 30 percent in 2009 to less than five percent by 2015.

It is also expected that:

The percentage of pregnant women attending ANC services counselled and tested for HIV should increase from 83 percent in 2009 to 90 percent in 2011 and maintained at 100 percent from 2012.

The percentage of health facilities providing ANC services that provide both HIV testing and ARVs for PMTCT on site should be increased from 66 percent in 2010, 75 percent in 2011, 80 percent in 2012, 85 percent in 2013, 95 percent in 2014 and 100 percent by 2015.

The percentage of infants born to HIV women who received a virologic testing from 6 weeks of birth increased from 13 percent in 2009 to 60 percent in 2011, 85 percent in 2012, 90 percent in 2013 and 100 percent in 2014 and 2015.

The percentage of HIV positive pregnant women who received anti-retrovirals to reduce the risk of MTCT increased from 48 percent in 2009 to 80 percent in 2011, 85 percent in 2012, 90 percent in 2013 and 100 percent in 2014 and 2015.

The percentage of HIV positive pregnant women assessed for ART eligibility through CD4 testing increased from 17 percent in 2009, 80 percent in 2011, 85 percent in 2012, 90 percent in 2013 and 100 percent in 2014 and 2015.

The National Aids Council says the thrust of the PMTCT is linked with and aims to achieve the MDGs 4, 5 and 6 which cover the reduction of child mortality, elimination of maternal mortality and combating HIV and Aids, respectively.
Mrs Swema Andifasi, the national PMTCT program officer at the National Aids Council says that the initiative aims to reduce child infections to levels so low that it is no longer considered a public health problem.

“MTCT of HIV is the commonest route of transmission in Zimbabwe and accounts for over 90 percent of pediatric infections,” Andifasi said in a presentation recently.
“Significant and substantial reductions in new pediatric infections can be achieved as a result of high coverage with effective interventions for PMTCT
“Reduced MTCT leads to reduced HIV-related morbidity and mortality among children.”

But its success depends on the participation of men.
“This is because men are the decision makers in most homes,” said Mr Richman Rangwani, founder and director of the Simbarashe Network of People living with HIV.
The Mhondoro-based organisation recently encouraged people to test for HIV publicly with the chief and headman of the area leading the way.

“If the father is involved he makes a decision and especially when they test positive they will decide on safe sex and pregnancy,” he explained.
Simbarashe Network has a “Gentlemen’s League” which brings men together to discuss the importance of PMTCT.
“We invite men to braai and other activities during which we stress the importance of the initiative. We seek to bring 200 men at one go.”

Mr Rangwani said national programmes should involve communities for them to succeed.
“Grassroots is where people are,” he said, “so resources should be mobilised to help the grassroots.
“If you look at the just-ended conference, you see it was too technical and the ordinary people could not quite follow,” he said.

The Ministry of Health has also developed an information campaign called “Zimbabwe communications strategy: Supporting the elimination of HIV infections in children and keeping mothers and children alive 201-2015.”

The strategy seeks to persuade women and their male partners to use available services and to take precautions to ensure they have healthy babies.
The second objective is to provide health facilities with equipment and tools to deliver effective HIV prevention and treatment.

The strategy also seeks to influence policy makers to regard the vision of eliminating new HIV infections in children as a national priority.
The strategy will mainly target prospective parents, women of child-bearing age, pregnant women and their partners.