Through PMTCT, we can protect future generations from HIV, says expert

As part of HealthNewsNG's special focus on HIV/AIDS, maternal and child health issues, Jennifer Ehidiamen spoke to Nurse Egga, an expert in Antiretroviral Therapy (ART) and Prevention of Mother-To-Child Transmission of HIV (PMTCT) who works in a general hospital in Nasarawa state, northern Nigeria. 

Her bubbling attitude and high-pitched voice resonate with her passion for the fight to ensure women living with HIV/AIDS lead healthy lives that are void of stigmatization and related challenges. 

She says she is not alone in the quest.

HIV/AIDS in Nasarawa state 

Nasarawa is one of the states with very high HIV prevalence in Nigeria. According to data released by the Nasarawa State AIDS Control Agency (NASACA), HIV prevalence rate in the state as at 2010 was 7.5%, with about 80,000 people currently living with HIV. 

Despite the high rate of infection, the state government in partnership with Institute of Human Virology Nigeria, are taking the lead in ensuring people living with HIV have access to treatment. A major focus has been the creation of Prevention of Mother To Child Transmission of HIV (PMTCT) centres in some hospitals. So far, there are about two hundred and fifty eight (258) PMTCT sites in Nasarawa.

In Nurse Egga’s opinion, when you prevent a mother from transmitting HIV virus to her unborn child, you are preventing the next generation from being infected. So when you are talking about Prevention of Mother To Child Transmission of HIV (PMTCT), it is a serious matter.

Nurse Egga represents the optimism many medical experts and stakeholders have in response to ending AIDS. She believes that it is possible to have a HIV-free generation. But there are still some challenges that need to be tackled.

Here are excerpts from the interview:

On tackling HIV/AIDS through PMTCT intervention

Nurse Egga: When we talk about HIV, it not a strange word anywhere. We know that the virus is fighting and we are also fighting within the medical setting. So when we are talking about prevention, we are talking about preventing the younger generation from being infected. By implication, any woman that steps into the hospital at any point either for antenatal or during an interactive session, we carry out this intervention to prevent the child from being infected.

Testing positive and child bearing

Nurse Egga: For most women that test positive, their responses are positive. But just like any human being, you have positive ones and you have negative ones. For those that respond positively, we normally have good result at the end. What do I mean by good result? It means that after one year and eight months of successful breastfeeding and weaning, we expect to get a negative baby [HIV Negative]. And so far so good, for the period of about 4 years of my being in the clinic, there is no woman that has successfully benefited from this PMTCT services that has come out with any positive baby.

All the positive babies we have had in this facility are from those that refuse to come for their PMTCT services.

Why some don’t women embrace PMTCT

[Stigmatization is still a big issue in Nasarawa state even though earlier this year the anti-stigma bill was passed into law at state level. Another challenge is the lack of support from spouses and family members of women living with HIV. Women who are not economically empowered depend solely on their husband for financial support. Where this support is not available, women are limited in their ability to access medical care as needed. The last but not the least is the challenge of poor counselling. If the women are not properly counselled before and after HIV test, they will not understand the treatment options available to ensure a healthy living.]

Roles of HIV/AIDS support groups

There are support groups available for women living with HIV in Nasarawa. We have the mother-to-mother support group, which is basically for the women alone. Then we have the Godiya support group [open to all]. When you talk about support group, it is not streamlined to PMTCT alone. During support group meetings, we normally talk about prevention so that those husbands that are in the general support group can also get to understand what we mean by prevention.

Challenges that threaten the service

Basically, as the ART nurse, some of the challenges I have encountered are:

• Poor road network: medical experts find it difficult to access villages due to poor road condition. Clients find it difficult to come to the facility for their treatment.
• Lack of support from spouse and family: if there is no support the husband may not likely give them [the women] transport to come. Some of the husbands even prevent them from taking the drugs [treatment].
• Stigmatization: The issue of pointing fingers. Stigmatization has been a very big challenge here. Some women are embarrassed to visit the PMTCT clinic for fear of being stigmatized.
• Lack of volunteers: When we are talking about prevention in the hospital, prevention at home- we are trying to prevent the next generation from being infected. So if there are volunteers in the community, we will have a wider scope of education. Doctors and nurses cannot leave the facility to carryout awareness campaigns in the villages.

Solutions so far

We have been to the villages even outside our catchment areas to educate people. We even use traditional rulers to tell the communities that by the time you don’t remove this stigma our clients will not come for their treatment. And when they don’t come for their treatment you are rest assured that you will have resistant virus within the community. The danger is that if somebody takes ARVs and does not continue and transmit the resistant virus to another person, then there is going to be trouble.

We also tell the husband that despite the fact that the woman is infected and you are not infected, the child she is carrying has the right to live and therefore we must put our heads together to ensure that we do something positive. As a result of this orientation, some husbands who are HIV negative have changed their attitude. Some even bring their wives to hospital and some collect drugs for them.

On the part of the community, we have not done enough due to financial constraint. Institute of Human Virology, Nigeria (IHVN) is supporting this site very well. But the challenges are numerous. We go for our outreaches once a month, which is not enough. Our home-based care is not effective due to lack of man-power.

Words of Advice

The advice I will give to the stakeholders is that we have gotten support from IHVN. We want the state government to also do something as a matter of charity so that this programme will be effective.

In fighting the virus, nutrition is the backbone… you and I also have a responsibility, charity organizations should also come in.

The Reporter
 

Jennifer Ehidiamen is a 2013 IRP New Media Fellow for International Reporting Project (IRP). She is reporting on issues of global health and development in Nigeria.