Gauging the Effectiveness of Prevention of Mother-to-Child Transmission (PMTCT)

Over the years, especially in the past ten or so, the world has been able to gain a foothold in the fight against mother-to-child transmission (MTCT) of HIV/AIDS. In some countries, the ones worst hit by the epidemic, results have shown that the gloomy clouds that were once prevalent have begun to retreat as the disease is slowly but surely being defeated.

One way that was used to combat this disease was by making sure that children born to an HIV positive mother were not infected too. By implementing prevention of mother-to-child transmission (PMTCT) methods, the rates of MTCT can be reduced. This comes from the results of many trials that have been done in various countries all over the world.

But, the question may be asked as to whether it really is true that the PMTCT regimen is as effective as it said to be. Well, one way that the effectiveness of the whole PMTCT campaign can be measured is by using a measuring method known as ‘PMTCT Cascade’1. The main principle behind this method is measuring the number of HIV positive mother and child pairs in a population that receives PMTCT intervention.  The data from all the facilities that provide the PMTCT services is collected and analyzed. The data is then divided into 7 areas.

These areas or groups are:

A: Attend institutional ante-natal care.

B:  Offered HIV test

C: Accept HIV test

D: Obtain HIV test results

E: Agree to HIV prophylaxis

F: Adhere to HIV prophylaxis

G: Adhere to infant ARV doses

Those that are grouped from A to C are mothers-to-be that come in for the ante-natal HIV tests, while those that are classified from E to G are those that have tested and found to be HIV positive. By covering all the expectant mothers in a community where the PMTCT intervention has been implemented, countries can gauge how effective their programs are. These results can be used to find out where the programs are failing. Needless to say, the number of women decreases as one goes down the A-G cascade. This, for example, can be because some of the women that had originally come in for the HIV test do not come back because they are either too afraid to accept their results or fear the stigma that will follow them once it is known that they are HIV positive. Therefore any country with such indicators can take extra measures to make sure that the community as a whole should learn more about living with people who are HIV positive in order to raise their awareness and remove the associated stigmatization.

1 – WHO: http://www.who.int/bulletin/volumes/86/1/07-043117/en/

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