A look back at PMTCT
In January, South Africa will begin initiating HIV-positive pregnant women on life-long antiretrovirals (ARVs). OurHealth looks at how far South Africa’s come in preventing mother-to-child HIV transmission.
Currently, all pregnant HIV-positive women receive ARVs during pregnancy and breastfeeding to prevent transmitting the virus to their babies. However, only women with CD4 counts, a measure of the immune system’s strength, below 350 currently will continue this ARV for life after weaning their children.
In January, all HIV-positive pregnant women who are diagnosed during pregnancy will be initiated onto ARVs for life – and other people living with HIV will be able to start ARVs at higher CD4 counts of 500.
But it was not always like this. OurHealth talked to Violet Ntuli who was diagnosed in 2007, when South Africa was still using a less effective, single dose regimen to protect babies. Ntuli found out she was HIV positive when she was 21 years old and expecting her first child.
“I was angry and disappointed,” she remembers. “I didn’t know what to do or to say to my mother about my status.”
[quote float=”right”]”I’m healthy and I’ve also informed my mother about my HIV status. I’m no longer afraid to drink my treatment in front of her”
“I received counselling from the lay counsellor at the clinic but nothing changed my mentality of anger and disappointment,” she added. “On my way back home, I decided not to tell anyone at home – including my parents – because I was afraid that maybe (they wouldn’t accept me).”
Ntuli gave birth in 2008, just after South Africa introduced dual ARV therapy to better prevent mother-to-child HIV transmission – on paper at least. Despite the policy change, Ntuli and her child received the country’s older and less effective PMTCT regimen.
“I continue attending the clinic until six months when they gave me one pill called nevirapine,” she told OurHealth. “(The clinicians) said I must drink it during my labour pains because it will reduce the chances of infecting my baby with the virus and advised me to carry it with me everywhere I went.”
Unlike today, where HIV-positive mothers on ARVs are advised to exclusively breastfeed children for the first six months of life, Ntuli said she did not breastfeed her.
“I didn’t breast feed him because I was afraid of infecting him,” said Ntuli who was not on ARVs during that time. “After six weeks, I took him for a blood test for HIV and he was negative.”
Now, Ntuli is on the country’s newly introduced fixed-dose ARV and open about her status to her mother.
“I’m healthy and I’ve also informed my mother about my HIV status,” she said. “I’m no longer afraid to drink my treatment in front of her.”