Uganda’s Child and Adolescent HIV Elimination Campaign is working to support pregnant women and mothers and their infants through a range of activities. When most of these women are young, an unprotected vaginal surface is the best option to prevent the development of HIV infection. Many women are under the age of 25. Others are 25 to 35 and show signs of pregnancy, including bleeding or vaginal dryness, which can facilitate transmission of HIV to the infant.
Child-birth can be risky for a woman, but if she does not have access to health care that includes sexual and reproductive health, she could be at a higher risk of acquiring HIV. Today, 75 percent of maternal deaths in Uganda are related to complications during pregnancy or delivery. Moreover, pregnancy and childbirth can be extremely dangerous and deadly in Uganda’s rural areas, where 1 in 2 new HIV infections occur.
Even if their medical history shows that the mother is healthy, there is a 1 in 2 chance that HIV-positive women will have vaginal herpes. It is a virus that is contracted during intimacy, during vaginal soreness, during sex, or during prolonged sex where the woman also kisses or enjoys the presence of genital herpes. Many women don’t know about herpes during pregnancy because they may be too embarrassed to seek medical attention. Or they may find it difficult to tell the doctor or nurse about herpes because of cultural taboos.
The majority of infected women don’t know that they have herpes and are unaware of what to do if they know they have it. By doing so, women can make a big difference in whether they have the opportunity to end HIV infection and save their newborn babies.
Fortunately, knowledge about herpes does not have to be a barrier to getting the preventative treatment. In Uganda, providers can prescribe preventative treatment for herpes, even if the woman is healthy. The only requirement is that a patient be evaluated for HIV. Then the treatment is added to a national treatment schedule in Uganda and at a local level. Treatments can be administered as a postnatal injection (fixed 12-week course) or oral spray. There are a variety of options available. Treatment requires dedicated follow-up, but the benefits are substantial.
Here’s how it works:
“Epidemiologic study findings show that voluntary medical male circumcision protects against HIV infection during sex,” said Uganda’s Minister of Health, Eric Kibitola. “Studies also show that herpes simplex-2 is present in 40 percent of the pregnant women in Uganda, some of whom may also be exposed to HIV. Therefore, prevention of HIV transmission through the use of oral sponges [a preservative] and penicillin during childbirth has the potential to make a real difference for women who are HIV-positive.”
Just four months after the beginning of the vaccination program, viral load levels in these women were found to be lower than what they were before the vaccination. Importantly, the rate of occurrence of herpes is reduced and the risk of transmission reduced, as well.
The large-scale of the program, with HPV treatments administered in at least eight different regions of Uganda — which have each average 130,000 births annually — provides significant evidence for the efficacy of this approach in preventing transmission of herpes simplex-2. There are also unanticipated benefits of the vaccination program — it makes mothers more trusting of the medical team and providers, reduces maternal trauma during delivery, and can give increased support to mothers-to-be and their partners.
“We have seen positive outcomes from this program,” Kibitola said. “Young mothers are more likely to get informed and are better able to listen to their family and health-care provider; their commitment to breastfeeding and antenatal care increases; and the amount of protective drug drops administered during pregnancy increases to 80 percent — from 35 percent. The program is making real progress on addressing the country’s HIV prevalence rate.”
To learn more about how the vaccine program can improve your own health and those of your family, call Uganda’s Ministry of Health directly: +254625553375
Women were the majority of new HIV cases in Uganda. While government efforts have been making progress in improving family planning in the country, women in Uganda continue to experience the highest rates of unintended pregnancy, which can double their risk of HIV infection. That’s why we at Planned Parenthood Federation of America are working closely with the Ugandan government to prevent these new HIV infections by enhancing services for new mothers, targeting services to the most at-risk populations, and providing free HPV vaccinations to thousands of young women.