Prevention of mother-to-child transmission of HIV
Aide Médicale Internationale

30 November 2011 - Preventing HIV positive mothers from passing the virus to their unborn baby (PMTCT) is an important part of the work that the Three Diseases Fund supports in Burma/Myanmar. Since 2007, 3DF has donated US$2million to four partners for PMTCT projects for this reason. This gave access to over 1,300 women to medication that helps avoid passing the infection to their children. One of our partners, Aide Médicale Internationale (AMI) is helping people in the Yangon area:

Ma San (not her real name) is a patient of AMI living in Dala Township, Yangon. When she got married to her second husband she had no children. U Win (not his real name) was keen to have a child so they decided to try and have a baby. Neither of them had much knowledge of HIV as they had not heard of it before. When she was pregnant for 5 months, she met with a traditional birth attendant who lives close to her. In line with her AMI training, the attendant advised Ma San that all pregnant women should have an HIV test for the safety of the child. Knowing that it can be a daunting task for anyone considering taking an HIV test the health worker accompanied Ma San to an AMI health centre in Dala for moral support. All HIV tests are offered with confidential counselling before and afterwards, regardless of the result.

The worst time for any participant is waiting for their test results. It is no wonder that Ma San became very stressed. During post-test counselling, she learned that she was HIV positive. Any feeling of hope drained away from her. No hope for her and no hope for her baby.

Her feeling of sadness and grief was completely overwhelming. While her concern for her baby grew, she also had to come to terms with how to tell her husband. The possibility that her husband will leave her and their baby was too much to consider. A glimmer of hope arose when AMI told her that they can provide medication that can potentially prevent her baby from contracting the virus. An AMI counsellor offered to help Ma San get through the difficult emotional period, giving her advice on how to break the news to her husband and her family, and also being available to answer any more questions about the delivery and the future. She found it very helpful and started making regular visits to the clinic even if it took four hours to walk there.

Ma San finally told her husband even encouraging him to take a test as well. His negative result comforted her and through counselling they both had a better understanding of how to practice safe sex. AMI tested her CD4 count (this indicates the stage of HIV infection in a patient by counting the number of a type of white blood cells which help fight infection). Her result was very low, 142 cells per microlitre. The World Health Organization recommends to start anti-retroviral therapy when CD4 is below 350. Ma San will have to take this for the rest of her life. AMI provides Ma San with the money to get to the clinic to ensure she can get access to her medication. In this case she only requests it when she is in difficulty. The welcome they both receive at the clinic helps them feel very comfortable as the staff show no stigmatisation and discrimination towards them.

With the limited means that U Win is able to bring in from his day work, he is able to take care of her. They still suffer from financial difficulties to buy food, which makes the food support that the World Food Programme provides from the clinic even more helpful.

Following consultations with medical staff on delivery procedures, the clinic offered the medication required to help avoid the baby getting HIV by the time she gives birth at the Yangon Women’s Hospital. The clinic also helped her with a lot of assistance following her son’s delivery. All to try and ease the transition of her and her husband into their new life changing situations. Ma San was soon back at the clinic, this time to share her experiences with other patients and to attend some support groups.

With the grateful support of AMI and the Three Diseases Fund the family is living a more normal daily life with a newborn son living without HIV.

Information of PMTCT programme in AMI

AMI has been operationing in Dala Township, Yangon, since 2001, and has been involved in STI prevention and treatment, and HIV prevention and care since 2005. AMI provides since 2007 services offering voluntary confidential counselling and HIV testing (VCCT), anti-retroviral therapy (ART), prevention of mother-to-child transmission (PMTCT) services, treatment of opportunistic infections for people living with HIV and STI diagnosis and treatment. These services are offered in three health promotion centres (HPC) ran by AMI, registered by the Ministry of Health as such, and located in Dala, Twantay and Seikki Khanaungdho townships, South Yangon District.

For further information, contact:

James Howlett, Communications Officer, Three Diseases Fund, Yangon

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