Prevention of Mother to Child Transmission

Prevention of Mother to Child Transmission

PMTCT program seeks to empower women of reproductive age living with or at risk of HIV through services meant to maintain their health and stop the transmission of HIV virus to the unborn child.                                                                                                                                                                        

This is offered before conception, throughout pregnancy, during labour, during breastfeeding and when breastfeeding ends. South Africa (SA) is committed to achieving the elimination targets outlined in the Last Mile Plan.                  
Whilst significant progress has been made in preventing HIV infections in children, HIV remains the third leading cause of maternal mortality, and a significant contributor to under-five deaths in SA.                                                                                                                                                                              
Therefore, managing the health of women living with HIV and preventing mother-to-child transmission of HIV remains a critical intervention for ensuring that women and children survive and thrive in South Africa.      
The PMTCT program outlines four pillars by which to achieve the targets of zero HIV transmission from mothers to their infants and an HIV-free generation.






PILLAR 1 SERVICE

Pillar 1 service is for HIV negative clients where service provider encourages clients about HIV prevention methods. The service includes the following:

    ∙ Safe sex education(use of condoms)

    ∙ Post Exposure Prophylaxis (PEP) and Pre-Exposure Prophylaxis (PrEP) as applicable & available

    ∙ Encourage healthy living/ lifestyle( no multiple sexual partners)

    ∙ Introduce family planning (Contraceptive methods) to women and girls of reproductive age.

    ∙ HIV Testing services (Encourage regular HIV testing)

These services are classified as Sexual Reproductive Health services and family planning in the activity form.


Pillar 2 service

This is for HIV positive clients where providers should conscientize clients on preventing unintended pregnancies and safe conceptions. For example, service providers should reinforce treatment adherence to all clients, however those who want to conceive should be urged to continue using condoms until they maintain an undetectable VL (<50) for 4-6 months before conception. If the partner is uninfected, consider PrEP for them. Once pregnancy is successful they should use condoms consistently to protect the child. For those who do not desire a child but might do so in the future, the provider should discuss options for contraception including long- acting reversible contraceptives and the DUAL METHOD. Alternatively, refer to clinic or Clinic Liaison Officer for further advice and counsel.

This has to be captured as ART adherence assessment and counselling support in the activity form.

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Pillar 3 Service

This service covers the Prevention of Mother to Child Transmission (PMTCT) programme for HIV positive mothers. If pregnancy is confirmed the mother needs to book at ANC before 14 weeks and continue using condoms during pregnancy and breastfeeding. Go for regular VL monitoring and maintain VL suppression in order to do exclusive breastfeeding and Prevent Mother To Child Transmission during breastfeeding. Refer to nearest local clinic/ CLO for more assistance and advice. Select PMTCT in the activity form.

Pillar 4 Service

This pillar takes a holistic approach to HIV prevention. Here service providers should provide appropriate treatment, care and support to women living with HIV, their children, partners and families. Support service include counselling, referrals and linkage to relevant resources for care and support, introduce to support clubs around the area, reinforce adherence to treatment, encourage VL suppression, check if they need support for family-centred disclosure of HIV status and advise. Couples Counselling and partner testing (SEE MONTHLY ACTIVITY FORM)

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