Reduction of Vertical Transmission of HIV Through the Use of Mother Buddies in Plateau and Kaduna States of Nigeria

Abstract

Background. Nigeria has the second largest number of People Living with HIV/AIDS (PLWHA) in the world. In 2009, of 27,870 Nigerian infants exposed to HIV, only 15,785 were on antiretroviral prophylaxis and 32% of the HIV-positive women received ARVs.It is now possible to reduce the rate of HIV transmission from HIV-infected mothers to their infants to less than 2%. While achievements in Prevention of Parent-To-Child Transmission (PPTCT) of HIV programmes or Prevention of Mother-To-Child Transmission (PMTCT) of HIV programmes are dramatic, these programmes need to be further improved and sustained. Methods. We developed “mother buddies” to improve access to PPTCT services in three underserved local government areas with 15 communities of Plateau and Kaduna States of Northern Nigeria in keeping with Dzama and Deakin’s pilot study in Malawi. Mother buddies are HIV-positive mothers who use Mobile Interactions bringing Hope (Mihope) phones to provide one-to-one life-saving support to vulnerable pregnant women and their families during pregnancy and for 6 months after child birth. The programme was implemented from October 2013 to March 2015.Life-saving support included information on HIV, PPTCT, family planning, Sexually Transmitted Infections, increasing male partners involvement and Antiretroviral(ARVs). Educational topics included the importance of attending antenatal clinic (ANC) before delivery, healthy diet patterns, partner testing for HIV, syphilis testing and malaria prophylaxis. Results. All education and support was accomplished on a one-on-one basis, thereby increasing knowledge, changing attitudes and practice. It also promoted health seeking behavior that improved access and uptake for PMTCT services in these rural areas. Of the 97 HIV--positive women, 64 gave birth safely and the babies received PPTCT/PMTCT Interventions. Forty-seven babies tested negative to two DNA PCR tests at 6 weeks after delivery and 6 weeks after cessation of breast milk feeding, while 17 babies tested negative to first DNA PCR, and were awaiting second DNA PCR after 6 weeks of cessation of breast feeding at the time of this analysis. Conclusions. Despite logistical challenges, security concerns and project design limitations, “Mother buddies” demonstrated the capacity to increase access to PPTCT/PMTCT services in hard to reach and underserved communities with great impact/outcomes.