In January, the country will introduce a big change in antiretroviral (ARV) treatment for pregnant women with HIV. Health workers in the Western Cape, which has been operating under the new treatment plan for over a year, warn that the change means more than just pills for expecting mums.
Currently, HIV-positive mums with strong immune systems, measured by a CD4 count of 350 or more, only receive ARVs during pregnancy, delivery and breastfeeding to prevent transmitting the virus to their babies. These women must wait until their CD4 counts falls to start ARVs for life for their own health – except in the Western Cape.
The Western Cape moved to Option B+ in July 2013. Women like Nopinky Matinise have been at the forefront of the roll-out of the new treatment guidelines. The province has also ramped up the number of ARV-providing sites and improved how health care workers track mums and babies.
Matinise was diagnosed HIV positive during her pregnancy in 2012.
“I thought I was dying,” says Matinise, who was then linked with the non-profit organisation mothers2mothers. Started in Cape Town, the organisation works across southern Africa to support expecting HIV-positive mums in PMTCT programmes.
“After I met mothers2mothers, I realised I was not dying and I got education,” says Matinise, who gave birth to an HIV-negative baby.[quote float=”left”]“We started seeing more partners coming because they wanted to know what was happening (and) why now women had to take ARVs for life”
But she could not shake the feeling that other mothers were still out there, scared and trying to cope with their HIV diagnoses while waiting for baby. When the opportunity to become a mother2mother mentor and give PMTCT counselling to other women arose, she grabbed it. She now works as a mothers2mothers site coordinator at Site B in Khayelitsha.
She says the move to Option B+ was a massive change for mums and counsellors.
“It changed the way we did our education generally, one-on-one and in support groups,” she tells Health-e News. “We had to make sure our women understood why it was important for them to start ARVs.”
It was especially difficult to get women living with HIV, who had gone through one pregnancy already under different guidelines, to understand why they needed to take ARVs for life although they felt healthy, Matinise adds.
Explaining that starting ARVs earlier would help keep them healthier for longer and decrease their risk of opportunistic infections such as tuberculosis helped, she says.
The mentor mum also says that more men piled into waiting rooms to hear more about what Option B+ meant for their partners.
“We started seeing more partners coming because they wanted to know what was happening (and) why now women had to take ARVs for life,” she says. “They also wanted to know about themselves asking why, if she was on ARVs for life, why weren’t they.”