South Africa's Prevention of Mother to Child Transmission (PMTCT) Programme has severe shortcomings that could be doing more harm than good. HIV patients are missing out on opportunities to receive a key intervention namely the nevirapine tablet according to a study published in the online open access journal AIDS Research and Therapy.
Lungiswa Nkonki, of the Medical Research Council, Tygerberg, South Africa, worked with colleagues from University of the Western Cape (UWC), Health Systems Trust and the Tulane School of Public Health and Tropical Medicine, New Orleans, USA, on the study.
The study's qualitative research with women who had participated in the public sector PMTCT programme revealed critical failures, not only in testing expectant mothers for HIV and giving them the results of the test, but also in a lack of intervention to help protect the unborn child from infection. A 50% reduction in transmission of HIV from mother to child is possible with the use of the drug, nevirapine, but this is not being administered routinely.
The research team interviewed 58 HIV-positive women in South Africa and collected detailed information about their experiences of antenatal care. They also investigated whether or not there were missed opportunities for participation in prevention of mother-to-child transmission programs.
Fifteen of the interviewees missed out on nevirapine, not because of the stigma associated with HIV/AIDS, nor ignorance, but because of health systems failures, say the researchers. Of the 15 women, six women were not tested for HIV during antenatal care. Two who were tested received no results and seven were tested and received results but did not receive Nevirapine.
"Health Systems failures within these programme ranged from non-availability of counsellors, supplies such as HIV test kits, consent forms, health staff giving the women incorrect instructions about when to take the tablet and health staff not supplying the women with the tablet to take," the researchers say.
Nkonki and colleagues make two simple suggestions. First, HIV testing should be strengthened to enable access to preventative interventions. Secondly, a combination of two or three antiretroviral drugs starting during pregnancy and continuing for one week after delivery should replace the single dose regimen to improve uptake as recommended by the World Health Organisation (WHO).
Source: BioMed Central
Related stories:
Psychosocial issues affect HIV/AIDS treatment outcomes
Psychosocial influences such as stress, depression and trauma have been neglected in biomedical and treatment studies involving people infected with HIV, yet they are now known to have significant health impacts on such individuals and the spread of AIDS, according to a University of North Carolina at Chapel Hill scientist.
Gender affects reaction to HIV-prevention materials
Various intervention strategies have been implemented to curb the rise of HIV, and a factor that might affect exposure to interventionsis gender. A new study in the
Journal of Applied Social Psychology reviewed the behavior of participants exposed to various HIV brochures. Researchers found that both men and women were likely to avoid gender-mismatched brochures. Women, however, were more likely to approach gender-matched brochures over gender-neutral brochures.
Extended infant antiretroviral prophylaxis reduces HIV risk during breastfeeding
In many resource-poor countries, infants born to mothers with HIV receive a single dose of nevirapine (NVP) and a one-week dose of zidovudine (ZDV) to prevent transmission of HIV from the mother to her newborn. The results of a randomized trial led by researchers at the Johns Hopkins Bloomberg School of Public Health and the University of Malawi College of Medicine found that extending the routine antiretroviral regimen can significantly reduce the risk of mother-to-child HIV transmission. The study is available in the June 4 online edition of
New England Journal of Medicine and will appear in the June 10 print edition.
Study says death gap increasing in US
A new study finds a gap in overall death rates between Americans with less than high school education and college graduates increased rapidly from 1993 to 2001. The study, which appears in the May 14 issue of
PLoS ONE, says the widening gap was due to significant decreases in mortality from all causes, heart disease, cancer, stroke, and other conditions, in the most educated while death rates among the least educated remained relatively unchanged.
Do antidepressants enhance immune function?
Infection with human immunodeficiency virus (HIV), which leads to acquired immunodeficiency syndrome (AIDS), is an epidemic of global concern. According to the most recent estimates, released in November 2007, by the Joint United Nations Programme on HIV/AIDS (UNAIDS) and the World Health Organization (WHO), an estimated 33.2 million worldwide are living with HIV infection currently. Although the rates of infection appear to be decreasing, there are obviously immense implications for achieving improvements in HIV/AIDS treatment.
Preventing mother-to-child HIV transmission in low-income countries
Can HIV transmission in pregnancy in low income settings be prevented with round the clock rapid testing in labor?
Life expectancy no longer improving for large segment of the US population
One of the major aims of the U.S. health system is improving the health of all people, particularly those segments of the population at greater risk of health disparities. In fact, overall life expectancy in the U.S. increased more than seven years for men and more than six years for women between 1960 and 2000.
Cutting through the stigma
Training community members such as barbers as peer educators can be an effective way of spreading information on HIV/AIDS throughout low-literacy, rural communities, say findings published this week in the open access journal Human Resources for Health.