“GETTING initiated on Antiretroviral Therapy (ART) as well as registering for the Prevention of Mother to Child Transmission of HIV (PMTCT) program early has been the best decision I have ever made,” said Tracey Makoni* (27) from Nyazura, in Manicaland province during an interview with HealthTimes on a media tour that was organised by the Family AIDS Caring Trust (FACT). Tracey has five children and even though they were born after she had already tested positive for HIV, none amongst them has HIV, thanks to the PMTCT program being offered at Nyazura Clinic.
By Michael Gwarisa in Manicaland province
The PMTCT program is part of the Children Tariro (CT) program being implemented by FACT through support from the United States President’s Emergency Plan for AIDS Relief (PEPFAR), the United States Agency for International Development (USAID) and the Ministry of Health and Child Care (MoHCC). Zimbabwe commenced piloting the PMTCT program using the World Health Organization (WHO) 2001 PMTCT guidelines. The guidelines recommended HIV-positive pregnant women to receive Zidovudine (AZT) for 4 weeks or a single dose of Nevirapine (sd-NVP) at the onset of labour to prevent vertical transmission of HIV. Vertical transmission (VT) of HIV is defined as that occurring from mother to child during gestation, delivery, or breastfeeding.
I am grateful that of all my five children, none of them is HIV positive as I enrolled for the PMTCT program on time. Through the teachings I got from FACT, I make sure that I take my medications on time and after birth, I would give my children their medications on time.
“As for my little baby who is now a year and 11 months old, at first I was afraid that she would be born positive since I gave birth to her at home at the height of the COVID-19 pandemic and I was not feeling well. However, when a dried blood spot (DBS) was done at six weeks, the results came out negative. When she was tested at nine months, her results still came out negative. As soon as I take her off breast-milk in April, I will take her for testing and I am certain she will still come out HIV negative,” added Tracey.
Tracey is amongst some of the many mothers in Nyazura directly benefiting from the Children Tariro PMTCT initiative. She is part of the 57 HIV positive women who have formed a club at Nyazura clinic where they receive lessons on breastfeeding, caring for their new babies even before they are born, treatment adherence, Gender Based Violence (GBV) prevention, amongst other issues. The Children Tariro project is being implement by FACT in Makoni, Mutare and Chipinge districts
Another woman, Memory Mushowe* (31) said before she was initiated on the PMTCT program at Nyazura Clinic, she had five still births.
“I now have my first child whom I can call my own and she is living HIV free. Before I conceived and carried my new baby’s pregnancy, all my babies would die at birth or soon after giving birth. I came here and got tested for HIV and my results came out positive. That is when I was initiated on ART. The Doctors specifically advised me to stick by my medications timetable and I did just that up until the day I gave birth,” said Memory.
After giving birth, Memory says her baby was put on the Nevirapine drugs for about two weeks to prevent any infection during breastfeeding or any means.
“They tested my child and she was negative and healthy. I am happy about this. I wish I had taken up the PMTCT program earlier, I am sure by now I would be having more than three children. Apart from offering me services that led to me having my child, FACT and the health workers at this facility also offered me counseling and psycho-social support (PSS).”
Mrs Violet Shiripinda, a Village Health Worker (VHW) at Nyazura Clinic said women were now knowledgeable with regards to PMTCT issues and this has seen a reduction in children being born HIV positive at Nyazura clinic.
“We have about 57 women we have in our program here at Nyazura Clinic and they are all HIV positive. However, from these 57 women, all their children and babies were born HIV negative and this just shows how effective the PMTCT program has been. The other good thing is that of all these 57 women who are HIV positive and on ART, only one has high viral load, this shows that they also appreciate that adherence is key,” said Ms Shiripinda.
Programmes for PMTCT of HIV include antenatal HIV testing and counseling, avoiding unintended pregnancy, provision of appropriate antiretroviral (ARV) regimen for mothers and new-borns, and support for safer infant feeding options and practices.
Sister Julia Sharaunga, the Acting Sister in Charge at Nyazura Clinic said the Children Tariro Program was offering a cocktail of services to HIV positive mothers and young adolescents living with HIV.
“The Children Tariro program has been running for a while now and has helped in ensuring that HIV positive mothers adhere to their medications. The program has been teaching them how to maintain their viral load, drug adherence and many others. The initiative also offered GBV services and counseling services to those who would have been abused at home because some of the husband s do allow them to take home the HIV medicines,” said Sr Sharaunga.
Nyazura Clinic has a catchment area of 2721 and serves communities Nyazura urban and surrounding locations as well as other areas outside their catchment area such as Mahere, Chakuma, Niro Forkington , West Valley and others.
Meanwhile, FACT Zimbabwe, Progamme Manager, Children Tariro and DREAMS programs, Delia Chimedza said under the FACT Zimbabwe Health and Nutrition Interventions, “One of our goals is to ensure that we attain an AIDS Free generation through supporting caregivers and children in high HIV burdened areas with unknown status are referred for HIV Testing Services (HTS). We also intend to strengthen community clinical linkages that facilitated treatment care and support to HIV positive children and their beneficiaries through the 95 95 95 UNAIDS goals.”
Zimbabwe has also adopted the ambitious 95-95-95 UNAIDS goals of containing and controlling the HIV epidemic by the year 2030 where the target is to ensure 95% of the people who are HIV positive know their HIV status by 2030, 95% of those who are HIV positive are on ART by 2030 and 95% of the people who are HIV positive are virally suppressed by 2030. Zimbabwe is one of the countries hardest hit by HIV in sub-Saharan Africa. To date, nearly 1.4 million people are living with HIV in Zimbabwe and more than 80,000 of these individuals are children under the age of 15.
*Names have been changed to protect the identity of beneficiaries.