The Gauteng government is actively expanding its campaign to prevent HIV positive pregnant women from passing the virus on to their babies, yet many mothers in the province are still reluctant to know their HIV status.
Government is offering the drug nevirapine to pregnant HIV positive women at seven hospitals and one clinic in the province. These are Chris Hani-Baragwanath, Coronation, Natalspruit, Pretoria West, Kalafong, Leratong and Carletonville Hospitals and JC Dumane clinic.
Nevirapine has been proven to cut HIV transmission from mothers to their babies by up to 50%.
However, in order to access the drug, the women have to consent to take an HIV test. Last month (JULY) only 513 women of the 1 249 attending ante-natal clinics at the East Rand and Pretoria sites agreed to take the test.
In previous months, about 60% of women have consented to be tested.
But Gauteng health department spokesperson Popo Maja says that the programme is generally going well, and there are plans to expand the programme to more places later this year and in the new year.
At Natalspruit, for example, over 70% of women agreed to be tested. Close to 40% of women tested at J Dumane were HIV positive, while this figure was over 30% for Natalspruit and Kalafong.
Maja says many women are still afraid to go for the test because of the stigma attached to HIV/AIDS.
The figure for Kalafong was particularly low, with less than 23% of women consenting to take the test. However, Maja said the reason for this was Kalafong is a referral centre that offers specialised care, so the women there already had problems with their pregnancies.
In a site in the Eastern Cape, Cecilia Makiwane Hospital, 57% of women agreed to be tested. However, in Paarl in the Western Cape, 95% of women accepted the test while in Durban this figure was 89%, according to a report to a meeting presented to Health MECs and the health minister last month.
The Western Cape is expanding its mother-to-child programme very rapidly and plans to make free nevirapine available at all health facilities in the province as soon as possible.
However, the other seven provinces are sticking to the national health department's stipulation that they set up two pilot sites each and monitor the progress of these sites over two years.
Government has been heavily criticised for being slow to implement the nevirapine programme, initially due to begin in all provinces on 1 January. Eight of the nine provinces finally have pilots sites, while Mpumalanga is due to start in a month's time.
The Treatment Action Campaign (TAC) will next month meet Health Minister Dr Manto Tshabalala-Msimang in court in a bid to force her to make nevirapine available at all state health institutions.
TAC points out that the current pilot sites only reach 10% of women, or 15 out of the estimated 150 HIV positive babies born each day in the country.
The drug is relatively simple to administer. A single tablet for the woman in labour and a spoon of nevirapine syrup for her baby with 72 hours of birth have been shown to reduce the transmission rate of the virus by up to 50%.
However, as breastfeeding can also transmit the virus, one of the biggest challenges for provinces lies in how to counsel women to feed their babies. Provinces are offering formula milk to women who have access to running water. In places where there is no running water, babies are more great danger dying from intestinal infections from unsterilised bottles or dirty water than from HIV. Mothers without access to clean running water are being advised to exclusively breastfeed for six months.
Health-e, 24 August 2001