PEPFAR Nigeria PMTCT Program Changes Lives

Patience struggled unsuccessfully to get pregnant before she discovered her HIV+ status. Having weathered the storm of HIV disclosure on her young marriage, another storm loomed on her horizon, or so she thought. She had to learn to accept a life of childlessness in a culture where inability to procreate is perceived as a curse.

Coupled with her struggle to get pregnant, she now needed to follow the controlled intercourse regime recommended for HIV discordant couples, her husband having tested negative. Sadly, a medical doctor had wrongly counseled her that HIV+ women do not procreate.

"I was devastated," said Patience. Her life changed, however, thanks to a staff member who referred her and her husband to a PEPFAR-supported site for counseling, where she became convinced that HIV+ women can and do have healthy babies. Interestingly, Patience got pregnant for the first time within six months. "My baby would be one year old tomorrow [September 18, 2008], and she is HIV free!" the proud mother exclaimed.

PEPFAR Nigeria, through its Prevention-of-Mother-to-Child Transmission of HIV (PMTCT) program, has established over 400 PMTCT sites across Nigeria which have provided initial screening to more than 220,000 pregnant women and provide ongoing services and support to over 12,500 women like Patience annually. The PMTCT program also provides HIV information brochures, early infant feeding and family planning options, and early infant diagnosis and treatment for HIV+ babies. Noting that support from the PMTCT program reduces the chance of a baby contracting HIV, Patience added "This gives HIV+ women the courage to procreate."

According to Centers for Disease Control and Prevention Chief of Party (Nigeria) Nancy Knight, one of the biggest challenges has been ensuring women return for follow-up care. "We had to be more proactive in the PMTCT program area. In Nigeria, 63% of women who register for antenatal care do not return to the clinic after their first visit."

To encourage regular visits, the PEPFAR Nigeria PMTCT program devised an incentive package called "Mama Packs," which it provides free to pregnant women to attract them back to the facilities so they can avail themselves of the full range of PMTCT services. The "Mama Packs" for pregnant women include basic care and hospital supplies, home visits, and registration of births.

"We have come a long way", says Christina Chappell, HIV Team Leader at USAID-Nigeria. Before PEPFAR, antenatal care did not include PMTCT as awareness was low and the facilities were just not there. As the PMTCT program continues to develop, the PEPFAR Nigeria team has built linkages to services for mother and child. Going forward, the team plans to extend PMTCT services to all the 774 local council areas of Nigeria to better serve the grassroots. "Our focus is on having an HIV free generation for our newborns", says Chappell.

For Patience, the support she receives from the PMTCT program has been a life changing experience. She is an ardent advocate for women’s health rights issues, especially economic empowerment so women in at-risk marriages are able to make better choices regarding their sexual health and rights ."‘I became so actively involved because I received support and encouragement from facilitators of the support group [a PEPFAR implementing partner] such that I wanted to give back to society. The PMTCT program of PEPFAR gives hope to women. HIV+ women like me know from experience that HIV is not a death sentence."