Half of HIV-exposed children in Africa not receiving drug to prevent infection

Published on AIDSmap, by Keith Alcorn, July 29, 2010.

A four-country African study of mothers with HIV giving birth in 2007 and 2008 has shown that up to half of children exposed to HIV during pregnancy and childbirth did not receive nevirapine to prevent HIV infection at the time of delivery.

Younger mothers and those who made fewer visits to the health facility before giving birth were significantly less likely to have taken a dose of nevirapine, and their infants were less likely to have received a dose of nevirapine after birth, according to results of a study published on 18 July in the Journal of the American Medical Association to coincide with the opening day of the Eighteenth International AIDS Conference in Vienna. 

Calls for a greater effort to employ proven interventions in the prevention of mother-to-child transmission are prominent at this year’s International AIDS Conference.

“The virtual elimination of mother-to-child transmission by 2015 is sacrosanct,” said Michel Sidibé, Executive Director of UNAIDS, in his plenary address to the conference.

Speaking at the Children First conference preceding the AIDS conference, UNICEF’s HIV & AIDS chief said: “In 2010 the stars are aligned for the elimination of vertical transmission. We can see the pathway to make this happen by 2015. The question is, how do we get systems to work together, how do we get programmes to talk to each other?”

Experts believe that vertical transmission – transmission of HIV from mother to child during pregnancy, delivery or breastfeeding – could be virtually eliminated by 2015 if national programmes are able to implement a number of key measures:

  • Adopting new WHO guidelines for prevention of mother-to-child transmission to ensure that the most effective regimens are being used, and moving towards earlier antiretroviral treatment for all women who are medically eligible.
  • Promoting integration of HIV services, maternal-child health services and family planning in order to reduce the number of unintended pregnancies.
  • Prevention of HIV infection of women.
  • Comprehensive care for families, particularly through integration of HIV into maternal-child health services.

However the research presented today, carried out by Jeffrey and Elizabeth Stringer of the Centre for Infectious Disease Research in Zambia and colleagues in Cameroon, Ivory Coast and South Africa, shows that there is still a long way to go to achieve high levels of coverage of the key interventions … (full text).

(Reference: Stringer EM et al. Coverage of nevirapine-based services to prevent mother-to-child HIV transmission in 4 African countries. JAMA 304 (3): 293-302, 2010).

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