PRESS RELEASES

Fact Sheet on Prevention of Mother-To-Child Transmission of HIV (PMTCT) in Nigeria to Commemorate International Women’s Day – March 8, 2007

FACT SHEET

1. What is International Women's Day about?

• International Women's Day is a United Nations commemorative event marked by women's groups around the world.
• The day is about recognizing women in the annals of history; it is about women in centuries-old struggle to have an equal footing with men to share in and contribute to society
• The U.S. Mission in Nigeria wishes Nigerian women a happy International Women’s Day 2007 celebrations
• To commemorate this event, the U.S. Government agencies implementing the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) will organize a press tour of the Prevention-of- Mother- to-Child Transmission of HIV facilities at Wuse General Hospital, Wuse Zone 3, Abuja the morning of March 8, 2007. 
• The purpose of this tour is to highlight the medical services available to HIV-positive pregnant women, including prevention of peri-natal transmission of HIV to the unborn child.
• We believe that this press tour will increase public awareness and the appreciation of services available to women as a special group, and contribute to bridging the widely acknowledged gender-gap in health awareness affecting women.

2. In what ways can HIV be transmitted from mother to child? 

• HIV can be transmitted from mother to child during pregnancy, Labour and delivery and during breast feeding
• Most of this transmission actually occurs during late pregnancy, labour and delivery and during breast feeding.
• The most important risk for this transmission is the amount of germ (virus) in the mother’s blood.
• The risk of transmission to the baby is greatest when this germ is high–which is often the case with recent HIV infection or advanced HIV/AIDS.

3. What are the chances of an HIV-positive mother transmitting HIV to her baby without intervention?

We use the word risk to define the chances of a mother transmitting HIV to her baby

• Not all infants born to HIV – infected mothers will become infected.
• During pregnancy - the antenatal period, the risk is 5 – 10%
• During labor and delivery the risk is 10 – 20%
• During the post partum (after delivery)with breastfeeding the risk is 10 – 20%
• So for non breast-feeding mothers the risk is 15% - 30% risk.
• Whilst for breast – feeding mothers the risk is 25% - 45% risk
• Most infants do not become infected even in the absence of treatment for the mothers.

What are the treatment options available to HIV-positive pregnant women?

Key Message – Pregnant women who are HIV-infected should be evaluated for Antiretroviral treatment as soon as possible

• The HIV – positive mother needs all the routine treatment given to a pregnant woman including iron and folate; multivitamin supplementation; tetanus toxoid immunization and malaria prophylaxis
• Antiretroviral drugs can be used:
• Three drugs (Highly Active Anti Retroviral Treatment) if the mother needs it for her own health.  Determination of this is made by looking at her CD4 cells.  CD4 cells are the body’s soldier for fighting infections and illnesses and are usually invaded by HIV.  CD4 cells die off slowly over a period of months and years.  As the number of CD4 cells declines- below 250, the body is less and less able to fight off infections and is said to be immune suppressed, and the woman would then need the three drugs during her pregnancy and afterwards.  Drugs are delayed until after the first trimester, unless the benefit outweighs the risk
• If the woman’s CD4 cells are still a good number (more than 250) she would not need the three drugs as above but would still need preventive drugs from 28 weeks to reduce the risk of transmitting HIV to her baby.  One or two drugs are used and at birth she gets a third drug. She then gets one week’s supply of two other drugs to support that single drug
• Some women do not come for Antenatal until they go into labor.  We recommend that every woman should know her HIV status before or immediately after birth.  So even if a woman presents in labor without knowing her status, she gets counseled, tested and if found positive she can still get a single drug before delivery that would reduce her risk of transmission of HIV to her baby.  She then gets a one week supply of two other drugs to support that single drug.
• If the woman’s CD4 count is below 200 – which means like we said above that she is immune suppressed, she would need Septrin once daily or every three days to protect her from certain illnesses.
• For delivery a planned Cesarean section can be done when feasible and safe.
• We also generally reduce the infant’s exposure to blood through careful obstetric practices.
• Once the baby is born – it gets a dose of medicine at birth and two other supporting medicines for six weeks.

What is PEPFAR

• PEPFAR or the Emergency Plan is an acronym for the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) 
• Nigeria is one of the Emergency Plan’s 15 focus countries.  The focus countries collectively represent approximately 50 percent of HIV infections worldwide.
• The Emergency Plan in Nigeria is coordinated by U.S. Ambassador to Nigeria, the Honorable John Campbell
• The programs support the HIV/AIDS prevention, treatment and care priorities of the Government of Nigeria. 
• Under the Emergency Plan, Nigeria received more than $70.9 million in Fiscal Year (FY) 2004, more than $110.2 million in FY2005, and approximately $163.1 million in FY2006 to support a comprehensive HIV/AIDS prevention, treatment and care program.
• PEPFAR is implemented in Nigeria though five agencies of the U.S. government in Nigeria namely, the United States Agency for International Development, Centers for Disease Control and Prevention, National Institutes of Health, Department of Defense, and the Public Affairs Section of the US Embassy
• The U.S.Government inter-agency team also works with the Federal Ministry of Health, the National Action Committee on AIDS and the Country Coordination Mechanisms (CCM) of the Global Fund to Fight AIDS, Tuberculosis and Malaria to assure integration with the Government of Nigeria programs
• Results have been achieved by the work of dedicated people in Nigeria, including faith-based, community-based and other humanitarian organizations. The Emergency Plan is strongly dedicated to supporting their efforts

How has PEPFAR helped Nigerian women in the area of prevention of Mother-to-Child Transmission of HIV ?

PEPFAR has through its implementing partners established 80 PMTCT sites in 12      states of Nigeria. These are FCT, Plateau, Kano, Benue, Anambra, Lagos, Oyo, Kaduna, Cross River, Rivers, Borno and Bauchi. This is projected to increase to 219 sites in 20 states of Nigeria by end of next year.  PEPFAR has also done the following:

• 111,813 pregnant women  have been counseled and tested with results
• 5,340 women have received ARV prophylaxis while an equally large number are on treatment.
• 1,610 health care workers have been trained on PMTCT

 Specifically,

• PEPFAR has equipped antenatal clinics and labor wards to provide PMTCT services
• It has trained doctors, counselors and laboratory staff on PMTCT and on application of these skills in health facilities
• Encouraged partner and couple counseling and testing 
• Its has provided drugs for use by pregnant women and their babies
• It has supported the establishment of support groups in health facilities
• It has started the Early infant diagnosis of babies born to HIV positive mothers
• It has linked HIV positive Mothers and there infants to long term care and treatment services