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Efforts to Stop Mother-to-Child HIV Transmission in Indonesia

Mother-to-Child HIV Transmission in indonesiaIn 2023, about 570,000 people in Indonesia were living with HIV. Recognizing the urgency, the Indonesian government intensified its efforts to support individuals and prevent mother-to-child HIV transmission. Community organizations play a crucial role in this endeavor, providing care and treatment access to those in need.

The Situation in Indonesia

Since 2008, UNICEF has supported the governments of Papua and West Papua in Indonesia in establishing a Prevention of Mother-to-Child Transmission of HIV (PMTCT) program. This program emphasizes HIV prevention, diagnosis and treatment within communities. Providing antiretroviral treatment during pregnancy can significantly reduce the risk of mother-to-child transmission. Ideally, since 2009, HIV testing should be part of antenatal care for pregnant women in Indonesia. However, more than a decade later, 37% of pregnant women still do not receive HIV screening. In 2022, only 18% of mothers with HIV accessed antiretroviral therapy.

Current Action to Prevent HIV Transmission

The National Alliance to End AIDS in Children, established in 2023, unites government, international organizations and civil society to improve access to health services and mental support for women and children living with HIV. The alliance focuses on three primary priorities:

  1. Advocating for the specific needs of adolescent girls and children living with HIV.
  2. Raising awareness by disseminating information about PMTCT (Prevention of Mother-to-Child Transmission), Early Infant Diagnosis and sexual education.
  3. Empowering communities to support children living with HIV effectively.

Importance of the Community

With renewed political commitment, supporting community-based services becomes crucial to providing necessary care and support for women and children living with HIV. Mobilizing community health workers is essential not only to prevent transmission but also to assist those affected by the disease. Organizations like Lentera Anak Pelangi (LAP), operating since 2009, play a vital role in this effort. As Indonesia’s first multidisciplinary service provider focusing on children with HIV, LAP collaborates with volunteers, sponsors and partners to enhance the quality of life for those living with the disease.

Key Focuses of LAP

  • Improving the Quality of Health and Nutrition. LAP offers health and nutrition assessments, family counseling and support during child hospitalizations. The organization also educates on sanitation and hygiene. Additionally, LAP provides monthly free medical checkups, non-BPJS laboratory testing and financial support for medications.
  • Advocating for ARV treatment. Its program raises public awareness about treatment options and conditions through training, social media campaigns and mass media efforts. It also extends its outreach to schools by educating both staff and students.
  • Ensuring the psychosocial well-being of children and their families. The program teaches children life skills and includes a school that monitors their development. It offers vocational training tailored to each child’s talents and interests. Additionally, the organization facilitates peer support groups for parents.

Providing a Community

A mother describes how her daughter’s confidence has grown since joining LAP, highlighting the friendships they have both formed with others in similar situations. Another parent comments on the bonds her son has created and the benefits he has received from LAP’s educational and nutritional support. Despite the stigma in Indonesia, where 33.5% of adults believe children with HIV should not attend school with uninfected children, programs like LAP play a crucial role. They counter isolation and stigma while ensuring families receive necessary support and help prevent the disease’s spread.

– Amelia Short

Amelia is based in Bradford, UK and focuses on Global Health for The Borgen Project.

Photo: Flickr

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HIV and Syphilis: Mother-to-Child Transmission in Belize

Belize Eliminates Mother-to-Child HIV and Syphilis TransmissionIn May 2024, Belize achieved certification from the World Health Organization (WHO) for eliminating mother-to-child transmission of HIV and syphilis. Over the past 20 years, in collaboration with the Pan American Health Association (PAHO), health care workers in Belize have dedicated themselves to enhancing medical services, ensuring a generation free from these diseases.

Improving Medical Services in Belize

Since the early 2000s, Belize’s health care services, in collaboration with the Pan American Health Organization (PAHO), have been following the organization’s Plan of Action for the Prevention and Control of HIV and Sexually Transmitted Infections. This initiative has improved and promoted access to prenatal HIV and syphilis testing. Health care providers now screen every pregnant woman for these viruses two to three times during pregnancy, at delivery and at 18 months postpartum.

The vastly improved testing services have reduced mother-to-child transmission in Belize, of HIV and syphilis by 81% from 2007 to 2023, achieving eradication by 2024. This success depended on effective treatments administered to pregnant women who tested positive for these diseases. For syphilis, health professionals administer three consecutive weeks of penicillin injections; HIV-positive mothers receive daily antiretrovirals along with prenatal vitamins. These treatments effectively prevent the transmission of HIV and syphilis to their children. To further ensure children are born virus-free, nurses follow up with mothers a week after treatment completion to verify the full course was administered and to identify any potential complications.

Encouraging Mothers to Seek Testing and Treatment

Throughout Belize’s collaboration with PAHO under its Plan of Action, the country has enhanced the research capabilities and capacity of its health care services, enabling more pregnant women to be tested earlier and more accurately for both HIV and syphilis. The percentage of women attending health clinics in their first trimester has risen to 90%, allowing for earlier and more effective administration of preventative treatments. When mothers test positive for these diseases, health care providers also encourage their partners to get tested, fostering community awareness and enabling more individuals to know their statuses and receive necessary treatment. As of 2022, 81% of people living with HIV in Belize are aware of their status.

Screenings and treatments in these clinics are free, ensuring that all women in Belize can access life-saving treatments for themselves and their unborn children. This accessibility has been crucial in eradicating the viruses and underscores the relentless efforts of Belizean health care workers. Additionally, if a mother misses an appointment, a nurse visits her home to conduct a follow-up check.

Nurses Maintaining the Transmission Rates

The critical roles of nurses in eliminating mother-to-child transmission of HIV and syphilis in Belize, particularly in remote areas like San Lazaro, are pivotal. The Belize Ministry of Health facilitates mobile health services that allow nurses to travel between villages to conduct screenings and treatments. This commitment underscores the dedication of health care workers to achieving the certification for eradicating HIV and syphilis transmission from mothers to their children.

Health care services in Belize actively educate and promote awareness of HIV and syphilis, encouraging mothers to seek regular testing. During prenatal checkups at clinics, health care workers emphasize the importance of screenings for both the women and their unborn children. This approach normalizes early testing upon pregnancy, increasing awareness and helping more women know their health status.

Testimonies from Belizean health care workers emphasize that their diligence, research and efforts are crucial for sustaining the elimination of mother-to-child transmission of HIV and syphilis. The Minister of Health and Wellness of Belize, Hon. Kevin Bernard, notes that cooperation and teamwork between health care workers and the communities they serve are essential for delivering optimal services and effectively preventing the spread of the disease.

Looking Ahead

The WHO certification confirming the elimination of mother-to-child transmission of HIV and syphilis in Belize highlights the success of the country’s health care workers and medical services. According to Dr. Natalia Largaespada Beer, this achievement not only ensures a new generation free of these diseases but also represents an opportunity to strengthen the health care system. The enhancement of services and nationwide access to life-saving treatments promise a bright future for Belize in sustaining this elimination, ensuring every child has the right to be born free from these diseases.

– Ben Kane

Ben is based in London, UK and focuses on Global Health for The Borgen Project.

Photo: Flickr