Prevention of Mother-to-Child Transmission of HIV

Since its founding in 2006, Fundacion VIHDA has worked in partnership with Ecuador’s largest Maternity Hospital in Guayaquil and the Ministry of Health to detect and treat HIV+ cases among pregnant women so they can receive treatment and their babies can be born healthy and HIV-free.

As of December 2014, we have conducted over 297,000 voluntary HIV tests among pregnant women, and detected and treated 1,425 newborns, bringing hope and the opportunity of a healthy life to our beneficiaries.

The Mother-to-Child HIV Prevention Program (MTC) provides early accesss to HIV testing during pregnancy, access to free ARV medicine, medical supervision, and prophylactic elective cesarean. Likewise, for post partum stages, we provide infant formula to prevent the risk of infection during breastfeeding, as well as medical controls for the newborn up to 18 months of age. These actions reduce the risk of mother-to-child HIV transmission to less than 2%.

Specifically, Fundación VIHDA contributes with the following actions within the MTC HIV Prevention Program at the Sotomayor Maternity Hospital:

Pre- and post- HIV test counseling to women who receive outpatient prenatal care, handing out informative materials to patients, creating and showing permanent audiovisual material for the reinforcement of educational information, and providing HIV testing and viral loads for affected women and children.

Fundación VIHDA’s staff provides comprehensive information on HIV to the women patients at the Maternity Hospital in a simple and relatable way. These brief talks spread awareness of the importance of early HIV testing during pregnancy and give information on treatment and all services that allow mothers living with HIV to give birth to healthy and HIV-free children. Informative materials are provided to strengthen these interventions, and educational health promotion videos are constantly shown in the available waiting rooms.

Psychological attention for outpatients

Finding out you have HIV is not an easy process. It can include a variety of guilt, sadness, anger and other crippling feelings. Hence our clinical psychologists and counselors are a critical part of our work attending HIV patients.

Our psychologists and counselors are highly qualified and specialized in caring for people living with HIV and their families. They provide services to all detected HIV+ women during pregnancy, working with them to properly navigate these early stages of diagnosis.

Parallel to our psychological care, VIHDA provides workshops to educate and strengthen patients on the following topics:

- Approaching HIV: demystifying the clinical picture

- Gestational development: fetal growth and body changes

- Nutrition during pregnancy

- Warning signs during pregnancy for prevention of preterm birth

- Preparation for cesarean delivery and alternatives to breastfeeding

- Understanding the benefits of the Ministry of Health’s National AIDS Program and other health services available to people living with HIV in Ecuador

- Alternative nutrition for non-breastfed children

- Adherence to ARV treatment for the new mother and her partner after birth.

- Early stimulation and communication between mother and child.

Our workshops also strengthen bonds with other mothers in similar situations, since peer counseling is fundamental in accepting the diagnosis and has been shown to be a vital tool for long term support among HIV+ women.

Emergency psychological attention to patients detected upon hospital admission

Some pregnant women are not diagnosed with HIV during their prenatal care for various reasons, and therefore their HIV status is detected at the moment of hospital admission to give birth. These mothers face a much greater emotional shock with much less time to process the information before delivery. Besides giving birth, they suddendly have to deal with fear for their health and their baby’s, fear of death, social rejection, an unknown treatment, etc. In these cases, emergency psychological intervention becomes key to provide the necessary support and guidance to reduce the initial impact and anxiety over diagnosis while continuing with the delivery process.

Continuing support for the affected family and reinforcement of adherence to the HIV treatment provided by the National AIDS Program

After birth, children receive outpatient medical care during the following 18 months to complete the prevention program. This continuing care is also an opportunity to remain in touch with parents and relatives of the child, provide psychosocial reinforcement, and to accompany families in this new phase.

Workshops to sensitize and increase awareness among medical personnel

The multidisciplinary team of the MTC HIV Prevention Program consists of highly qualified professionals with extensive training in caring for people living with HIV. Considering the constant turnover of medical residents common in hospitals, the maternity hospital staff and VIHDA’s own staff periodically provide workshops to inform healthcare professionals of new developments. This ensures that the medical team at the maternity hospital is always trained and updated with the latest research and practices.

Processing HIV tests and measuring patient viral loads

Early HIV detection in pregnant women is vital so that women can begin treatment as soon as possible and ensure the delivery of a healthy, HIV-free baby. Fundacion VIHDA contributes laboratory technicians to test thousands of pregnant women each month at the maternity hospital. Likewise, they take blood samples of HIV+ women in treatment to measure their viral load and better gauge the ARV dispensing protocols during labor and birth.

Results of the MTC HIV Prevention Program: Healthy Babies

All of us at the MTC HIV Prevention Program, including Fundacion VIHDA and hospital staff, and of course the brave women we work with, look forward to the day that each baby is formally declared HIV-free.

Starting in 2007 and each year thereafter, we host a “graduation” ceremony for the boys and girls who have completed their health checks in the MTC prevention program. This is a moment to celebrate and confirm that all our efforts have been worthwhile. Mothers, doctors, psychologists, counselors, nursing staff and everyone who forms part of the MTC HIV Prevention Program are happy to declare victory over HIV infection and share a moment of fun with entertainment and gifts for the children in attendance.

In Conclusion:

The prevention of mother to child transmission of HIV is the reason we all work hand in hand. Together as a team, Fundación VIHDA, the Maternity Hospital and the Ministry of Health strive to honor the women and babies in our program by showing them that, with appropiate medical care and supervision, HIV can be defeated.

Translated by Rachel Mestnik, Peace Corps 2014; edited by Fundacion VIHDA.

 

SOBRE NOSOTROS

Somos una organización ciudadana sin fines de lucro que:

Lucha por detener la transmisión madre-hijo del VIH durante el embarazo, parto y lactancia.
Educa sobre qué es, cómo se transmite, cómo se previene y cómo se trata el VIH/Sida.
Promociona la realización y fácil acceso a pruebas voluntarias de VIH.
Asiste a personas viviendo con el VIH/SIDA a acceder a servicios médicos, psicológicos y sociales disponibles.