Prevention of Mother to Child Transmission of HIV (PMTCT) and Option B+
MSH fully supports UNAIDS’ Global Plan Towards the Elimination of New HIV Infections Among Children by 2015 and Keeping Their Mothers Alive which aims to decrease the number of new pediatric infections by 90 percent and halve maternal deaths from AIDS by 2015. In 2011, only 45 percent of women had access to prevention of mother-to-child transmission of HIV (PMTCT) services and, of those that did, many could not complete the treatment due to inadequate access to care. To address these challenges, MSH works with international ministries of health, non-governmental organizations, and field experts to explore and apply evidence-based best practices for PMTCT.
Prevention of Mother to Child Transmission of HIV (PMTCT) Option B+ Project
Traditional approaches to PMTCT require a specific CD4 cell count before initiating antiretroviral prophylaxis. Unfortunately, access to reliable CD4 testing is limited in many resource-constrained settings and women often do not have access to consistent PMTCT services. To address these barriers, MSH worked with the Ministry of Health in Malawi to develop the Option B+ approach. This approach offers all HIV-positive pregnant women lifelong antiretroviral therapy, regardless of their clinical stage or CD4 count, thus streamlining the PMTCT process. Option B+ has been fully adopted by the World Health Organization and MSH is supporting Option B+ implementation and scale up in several countries. In August 2013, MSH and the US Centers for Disease Control and Prevention (CDC) will begin a four year evaluation of Malawi’s Option B+ program by following cohorts of mother-infant pairs to determine HIV-free survival following B+ initiation.
Ethiopia Network for HIV/AIDS Treatment, Care, and Support (ENHAT-CS) Project
In mother support groups, pregnant women newly diagnosed with HIV are mentored by women who have previously gone through this life-changing event. An evaluation of this approach found that, among infants whose mothers were enrolled in a support group, HIV prevalence was 57% lower than among infants whose mothers were not enrolled in a support group. Through the ENHAT-CS project, MSH integrates mother support groups with HIV care so that mothers can help one another adhere to PMTCT regimens and protect their babies from HIV. MSH is also supporting the government of Ethiopia in rolling out Option B+.
Prevention and Organizational Systems – AIDS Care and Treatment (ProACT) Project
Research shows that when men are educated about HIV & AIDS and encouraged to become involved in their partners’ and children’s health, there is a dramatic improvement in the success of PMTCT. In light of these findings, MSH’s ProACT project is promoting HIV & AIDS prevention, care, and treatment in Nigeria by increasing male involvement in maternal and child health activities.
Strengthening TB and HIV/AIDS Responses in Eastern Uganda (STAR-E) Project
Through the STAR-E project, MSH actively supports the roll out of Option B+ in Uganda, the second country to formally adopt Option B+ as a national strategy. The project team provides training, supervision, and support to 141 health facilities that provide PMTCT and the full range of other HIV services.