Community Responses to Paediatric HIV
Objectives of the radio programme
1. To explain that the problem of HIV in children is a community issue
2. To educate communities on what they can do
3. To encourage community members to play their part
Introduction
· Of the estimated 1.2 million people living with HIV in Uganda, 610,000 are women and 150,000 are children
· For children under the age of 5 years, Mother to Child Transmission is the only source of infection.
· Of the 1.4 million women who get pregnant annually in Uganda, 91,000 are HIV positive. This means an equal number of babies are at risk of acquiring HIV in that same year.
· The problem is therefore widespread in Uganda with no community spared the realities of HIV
· The only way Uganda is going to change this, is for communities to play an active role in addressing the epidemic
Community Responses
· The interventions that will help to reduce both Mother to Child transmission of HIV as well as care and treatment for those children that are infected, are well known and documented. Nevertheless, only with community participation will these be successful.
· Communities need to work together to create environments where the following strategies can be adopted:
o Testing of all pregnant women
§ Testing for HIV is the gateway to receiving critical services that can save lives. Only once a mother’s HIV status is known can she be advised on accessing PMTCT services to minimise the chances of passing the virus onto her child. Communities, should therefore encourage pregnant women to test.
o Delivery in health facilities
§ Although many women attend antenatal visits, only 42% deliver under the care of a skilled health worker. It is important for communities to recognise that delivery in a health facility ensures that mothers are attended to by skilled personnel. They are trained to address any complications and to administer the services that will help reduce transmission. Many communities prefer and support TBAs, but must instead work with them to get women to deliver in health facilities.
o PMTCT for all women who test positive and their newborn babies
§ PMTCT does not end when the woman has delivered at the health facility. Mothers must bring their newborns back to receive a dose of Anti-retroviral drugs (ARVs). This is critical. Communities must encourage mothers to follow through with this. It is the difference between their child getting HIV or not.
o Male Involvement
§ Very few men participate or play an active role in Maternal and Child Health. Due to their status in communities, men can positively influence the health of women and children by supporting health care seeking behaviour. This includes supporting their partners to go for antenatal care, to test for HIV and to take up PMTCT. They can also be a great support in ensuring that children in their care are tested and stick to ART regimens if positive and eligible.
o Cultural practices.
§ A number of practices that are engrained in our societies through culture, actually perpetuate transmission of the HIV virus. Women bear the brunt of infection in Uganda, and if infected, they may pass on the virus to the children that they bear. Communities must recognise cultural practices such as Female Genital Mutilation, widow inheritance, polygamy, multiple concurrent partnerships as putting women at high risk of HIV.
· Everyone has a role to play in addressing HIV in children. It starts within the home and then extends to sharing information with relatives, neighbours and all those within our reach. They must be encouraged to adopt behaviours that help improve the lives of children living with HIV. This starts with testing and sticking to ART regimens if they are eligible.
· Communities also have to recognise that HIV is a reality, but one that they can fight together. Accepting people living with HIV is critical, because it creates an environment where stigma and discrimination are not given the opportunity to thrive. Where there is a supportive environment, people are more empowered to seek the services they need to greatly improve their quality of life.