Five Lives: Preventing transmission of HIV from mother to child

Source: Doctor s Without Borders
26 October 2011

Kenya 2011 © Sven Torfinn

“Lucky was born negative because I already knew my HIV status and I got the help from the clinic I needed.:

Catherine Atieno is HIV positive and the mother of four children. She lives in Kibera, a slum on the edges of the Kenyan capital where she works in the local MSF clinic. Her daughter Joanne, was born with the HIV virus before Catherine knew her own HIV status. Lucky Grace, her youngest daughter was born after Catherine started antiretroviral treatment and doesn’t have the virus.

Nine in ten of the 2.5 million children living with HIV acquired the virus from their mother either during pregnancy, birth or the breastfeeding period. But these infections are entirely preventable, by putting the mother on HIV treatment, as well as the baby on prophylaxis at birth and during breastfeeding. In wealthy countries paediatric HIV has almost been eliminated with the risk of transmission cut to 2%. Expanding prevention of mother-to-child transmission (PMTCT) services could ensure that many other women, like Catherine Atieno from Kenya, are able to protect their families from HIV.

“Lucky is a healthy girl. When I was pregnant, the doctor said maybe either I will die or she will be born HIV positive. But when she came out, she was just normal – that’s why I decided to call her Lucky.”

Shortly after Catherine started antiretroviral treatment, she discovered she was pregnant with her fourth child. She feared that she would pass on her HIV infection to her child. Three years earlier, her elder daughter Joanne was born with the virus when Catherine did not know she was HIV-positive.

Catherine confided her fears to a friend who worked in one of MSF’s clinics in Kibera. As a result, Catherine enrolled in the Prevention of Mother to Child Transmission programme at the clinic.

Catherine was already taking antiretroviral drugs for her own health. And during delivery of her baby, the child was also given medication.

“Lucky was born negative because I already knew my HIV status and I got the help from the clinic I needed. My dream came true.”

The family is very close. Lucky is a constant source of delight. And Catherine is very protective and loving too, of Joanne, her older daughter who contracted HIV before Catherine knew her HIV status and could get the medical care to reduce the risk of transmission of the virus. But she has great hopes for all of her children and their future together.

“Now I can say that I am changing my life. I am really working hard, trying to make a business and earned some money that is really helping me to pay for my children to go to school.”
What it costs to help prevent the transmission of HIV to newborns and infants:

It costs roughly US$150 per year for the medicines for a pregnant woman for her own health, although much less if she needs a short-course for prevention.
It costs around $40 for the medicines for the child for a one year treatment period.
With access to antiretroviral medicines and appropriate health care, more than 98 percent of pregnant women with HIV do not pass the virus on to their babies.
An estimated 370 000 children were newly infected with HIV in 2009, the vast majority of them through mother-to-child transmission. Half of those are likely to die without HIV medication before they are two years old.

MSF provides PMTCT services in all of its HIV/AIDS programmes in 19 countries. In Khayelitsha, South Africa, MSF and the South African government have helped to reduce transmission of HIV by 250% down to similar transmission levels in developed countries.

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