HIV: More babies getting infected despite PMTCT intervention

The National Aids Control Programme (NACP) says there is an increase in HIV mother-to-child infections despite the implementation of the Prevention of Mother To Child Transmission (PMTCT).

Dr Stephen Ayisi-Addo, Programme Manager of the National Aids Control Programme (NACP), said the situation was due to a lack of testing and adherence to medication by pregnant women, hence the continuous infection from mothers to their babies.

At the 2023 dissemination of National HIV estimates, Dr Ayisi-Addo expressed concern that facilities continue to record newborn babies infected with the virus, which is a transmission from the mother to the baby.

The Prevention of Mother To Child Transmission (PMTCT) is one of the interventions instituted by NACP, Ghana Aids Commission (GAC), and partners to ensure the prevention of HIV transmission from mothers to their babies.

With the intervention, pregnant women would have to get tested for HIV at Antenatal care service and those found positive would be put on medication to protect the baby from getting infected.

The National HIV estimation showed that 12,108 mothers, aged 15 to 49 years, are receiving Prevention of Mother To Child Transmission (PMTCT) treatment.

It also indicated that 13,445 mothers needed PMTCT between the ages of 15 to 49 years.

He noted that many of the babies contracting HIV from their mothers were babies from mothers who missed testing during ANC, saying, "We are talking about covering about 90 per cent of all ANC attendance for HIV testing, so those who come in late do not get the treatment to prevent the mother from transmitting to the baby.

"We need to be able to improve the ANC testing coverage. We need to improve so that people will have supervised delivery on the routine services offered when pregnant women come to the facility," he added.

The Programme Manager also indicated that a lack of adherence to taking their medication by HIV-infected mothers was causing transmission from mothers to their newborns.

He said even with those tested and identified, not all of them get the antiretroviral treatment to prevent mother-to-child transmission.

Besides, out of about 6,000 PMTCT facilities, just 730 are delivering ARV.

Dr Ayisi-Addo said at facilities where there was no PMTCT coverage, pregnant women would have to be transferred to other facilities for such services, but they refuse to go due to transportation issues, hence the new strategy to decentralise antiretroviral therapy across all centres.

He said postnatal transmission was also occurring due to exposure to breastfeeding.

As part of the interventions, the national response programme had instituted strict infant feeding guidelines for HIV-positive mothers to prevent transmission.

However, some mothers are unable to adhere to the guidelines, and such gaps are contributing to the continuous records of transmission.

The programme manager acknowledged that the infant feeding guidelines for persons living with HIV had been reduced due to the unavailability of trained service providers to educate the mothers as they missed the appropriate feeding procedure, getting their babies exposed to the virus.

"It is our aspiration and determination to make sure that we address all these issues and improve on strategic interventions to improve the figures and reduce mother-to-child transmission to at least 2 per cent, which is an elimination target."

Dr Stephen Atuahene, Director General of the GAC, said strict adherence to treatment was key as it suppressed the virus and would help to avoid perinatal transmission.

He said it was important for HIV-positive women to achieve viral suppression before getting pregnant and necessary to maintain the suppression status, saying, "It is also the responsibility of the mother to adhere to treatment, maintain viral suppression status, and avoid transmission.

"As long as you can do that, you have a better chance of averting transmission to your baby, and so adherence is very crucial to all persons living with HIV and taking the medication. This is so important for mothers because every woman will want to have a healthy baby and therefore you have to avoid any risk that will expose your child to infection."