Stigma is undermining uptake of paediatric HIV prevention and AIDS treatment services in Uganda.
Stigma is undermining uptake of paediatric HIV prevention and AIDS treatment services in Uganda, the Ministry of Health has said.
Dr Peter Elyanu, the national coordinator for paediatric and adolescent HIV care, noted that whereas mothers are expected to come for Prevention of Mother to Child Transmission (PMTCT) services to protect their babies from infection, many are shunning the interventions for fear of revealing their sero-status.
“As of June 2012, only 68% of positive pregnant women received ARVs for PMTCT, and only 38% of their babies were returned for ARVs prophylaxis after birth,” Dr Elyanu revealed. “The mothers give us wrong addresses to avoid being followed up hence exposing their unborn babies to HIV infection. They even rub codes off their health cards that enable health workers to identify HIV exposed infants for appropriate diagnosis and care.”
Dr Elyanu was speaking at a regional paediatric HIV and Early Infant Diagnosis (EID) stakeholders meeting organized by the USAID Strengthening TB and AIDS Response project, and implemented by the Elizabeth Glaser Pediatric AIDS Foundation (EGPAF) at Lake View Hotel in Mbarara district. The meeting attracted over 70 health workers including district health officers, health centre in-charges, doctors and midwives to identify the gaps and challenges in EID of HIV, paediatric care and treatment.
According to the World Health Organization, without diagnosis and treatment about 35% of HIV-infected pregnant women will transmit HIV to their infants. However, there are key interventions that can reduce mother to child transmission of HIV to less than 5%. They include routine HIV testing and counselling of all pregnant women; provision of antiretroviral drugs (ARVs) to all HIV-positive women during pregnancy, birth, and after delivery; preventive therapy with ARVs for infants born to HIV-positive mothers; and safe infant feeding to minimize transmission.
Elyanu noted that in 2012 only 4% of children who received the full cascade of these PMTCT interventions got infected with HIV, compared to 12% who received only partial treatment, while a staggering 35% who did not receive any of these services got infected.
“The package must be complete and mothers must seek the PMTCT services,” Elyanu explained.
The Ntungamo district health officer, Dr Richard Bakamuturaki, urged government to explore strategies to increase uptake of paediatric HIV services, especially EID since it’s the entry point for care and treatment of children less than five years of age.
“Every child should be born free of HIV. Let us test every mother during antenatal and offer preventive services. And for those children who turn HIV positive after delivery, let us make sure that we don’t lose them,” Bakamuturaki said.
The Kanungu district health officer, Dr Steven Sebudde, said that shortage of testing kits in lower heath facilities and limited skills of health workers to manage paediatric HIV undermines EID and initiation of children on ART.
“Sometime we don’t have the testing kits which has affected the number of children eligible to start on ART,” he said. “We also need continuous on-the-job training to manage these children.”
Dr Mary Namubiru, the director of clinical services STAR SW, called for ‘creativity’ in increasing uptake of paediatric HIV services.
“We should strengthen the ‘Know Your Child’s Status’ campaigns to increase community awareness of the benefits of paediatric HIV/AIDS diagnosis, care and treatment,” Namubiru said.
She appealed for overall improvement in the quality of paediatric HIV care services in health facilities through strengthening counselling services, actively implementing follow-up of late patients; enhancing laboratory capacity, transportation of blood samples and results; and continuous on-site mentorships for health workers.
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