Uganda: Eliminating mother to child transmission of HIV

In Uganda, eliminating the transmission of HIV from mother to newborn child is no longer a dream but a possibility. Yet it remains one of the country’s greatest challenges.

In Uganda, eliminating the transmission of HIV from mother to newborn child is no longer a dream but a possibility. Yet it remains one of the country’s greatest challenges.

“When we started taking antiretrovirals my wife was not pregnant,” says James Opio, an unemployed man from Serere District in Eastern Uganda who is living with HIV. His wife, Josephine Amodoi, also has HIV and when she became pregnant the couple feared their baby would test positive for the virus.

“When she became pregnant, we went the health facility where we got counseling as we continued taking our medicine,” Opio says.

HIV prevention for newborns

“My wife gave birth to a baby boy, whom we named James Aliau. After my wife delivered, the baby was put on Nevarapine. We were told to return back to the health facility so that the baby could be tested.

“The baby was then put on Septrine. We were told to take the baby back to the health facility for another HIV test after three weeks. The results where negative and we were told to take the baby back for another test after one year.

“We were told to breastfeed the baby exclusively and never to feed the baby on any other food until the baby was six months old. After six months, the child was again tested and found HIV negative and we were given a certificate to declare that the child was now free from HIV.”

Option B+ campaign

According to Avert, most children living with HIV are infected through transmission from mother‐to‐child, and in Uganda at least 20 per cent of new infections occur this way. Without treatment, at least half of these children die before they reach the age of two.

Yet Opio and Amodoi went on to have three more children born free of HIV and their story reflects the increasing number of people living with HIV in Uganda whose children are being born HIV negative.

In 2012, Uganda began Option B+, a campaign to eliminate mother to child transmission of HIV. By March 2013, 48 per cent of all health facilities in the country offered services to eliminate mother to child transmission. By the end of 2013, all 112 districts in the country had at least one health facility providing these services (UNAIDS).

Sarah Opendi, the minister of state for primary healthcare, says by 2013 the number of children born with HIV had dropped to 9,500. This number stood at more than 15,400 in 2012, before the campaign began, according to UNAIDS.

Time to accelerate progress

Although progress has been good, UNAIDS country director Musa Bundugu says Uganda must do more to accelerate these efforts.

“To have 30,000 babies HIV positive – why, when we know we have the technology? If there is will and commitment there should be no reason why, at least in the next five years, any child should be born HIV positive in Uganda.”

Uganda’s first lady, Janet Kataha Museveni, the champion of the eliminating mother to child transmission of HIV campaign, says fathers must play their part if the campaign is to succeed.

“I am appealing to men to walk the nine months of pregnancy with their wives,” says Kataha Musevini. “The testimonies by children here who were born by parents who are living with HIV is a clear indicator that Uganda can achieve an HIV-free generation.”

Augustine Lemukol Osuban, the paramount cultural chief of Iteso, said men should embrace accompanying their wives to the health facilities and test together.

“Our major challenge is ignorance,” says Osuban. “We must all go and test for HIV. Previously, it was not possible to stop a baby from contracting HIV but now it’s possible if we embrace the advice given to us by health workers.”

Opio himself admits he was reluctant to test for HIV after Amodoi tested positive but a series of meetings and counseling sessions finally persuaded him. He is now a member of a village health team and an ‘expert client’ who encourages other men at Serere Health Centre 1V. “We now dedicate all our efforts to mobilise parents to embrace the services to prevent mother to child transmission of HIV,” says Opio.

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