Even though the Prevention of Mother to Child Transmission (PMTCT) testing has risen from 49 percent in 2002 to 93 percent by 2009 and the program uptake standing at 94 percent from 27 percent in 2002, the Department of HIV/ AIDS Prevention and Care (DHPC) is worried about repeated unplanned pregnancies in HIV positive women.
The Director of the DHPC, Tebogo Madidimalo, told the Sunday Standard that though it is not wrong for an HIV infected woman to conceive, it should be done carefully and through contact with a physician.
“A pregnant woman can have children but she has to plan the pregnancy well involving health care practitioners to monitor her properly and for her to be enrolled in the PMTCT program.”
He said that HIV positive women should consider the fact that pregnancy in itself is a taxing condition to the body.
“We have noticed that pregnancy increases the viral load in the woman’s blood and can lead to an increased transmission rate,” he said.
The DHPC is also worried about lack of partner support where HIV treatments and programs are concerned.
“A lot of men are not supportive of their partners; they do not want to test with their partners, and only 15 percent of our population has tested together as couples. Women are the only ones who are burdened with the PMTCT program whereas males are rarely involved,” Madidimalo said.
He also revealed that men rarely disclose their status to their partners, putting them at risk of infection.
“You find that the man would just pretend as if all is normal, caring less about the well being of the woman.”
The department says it intends to make a greater call for male involvement in maternal and child health.
Meanwhile, HIV prevalence stands at 31.8 percent in pregnant women aged between 15 and 49 years. This shows a recorded decline from 36.2 percent in 2001 and 33.4 percent in 2005.
The 2008 Botswana Impact Survey III indicated a national prevalence rate of 17.6 percent with the rates of females and males being 20.4 percent and 14.2 percent, respectively.
While Botswana has made significant strides through its committed political leadership, strategic partnerships and alliances in mitigating the impact of HIV/AIDS, the battle of the scourge is far from over as there are even more emerging challenges.
During a media briefing organized by the DHPC on Thursday, Madidimalo told the media that among the challenges is the growing number of adolescents living with HIV.
“It is quiet a challenge for the children who are approaching puberty and are taking ARV, this presents a case of hormones and the effect of the medication on the bodies of the individuals,” he said, adding that the HIV infected children attending schools are also subjected to stigmatization.
Other than that, Madidimalo said that even though media campaigns undertaken by the government and other bodies concerned with HIV have imparted a lot of knowledge about HIV/AIDS, they have not actually translated into positive behavioral change.
Chief amongst the department’s concerns is the prevalence of multiple concurrent partnerships (MCPs). Madidimalo revealed that it is very important that MCPs be reduced to the lowest degree possible while those cultural norms that encourage them should be discouraged.
He also said that worrisome is also the reluctance of parents to HIV-test their children.
“Many mothers and caregivers do not bring their children in for HIV testing despite their being HIV positive and knowing fully that their children had been put in the PMTCT program,” he asserted.
After the first test after birth, caregivers are supposed to bring in the child for testing after six months and annually thereafter.
Ms Elizabeth Koko, from the same department, said they have also noticed that participation from communities on HIV issues is very inadequate. She said this could be because community members have no competency on health issues.
Koko also said that a lot of Batswana are carefree about HIV and therefore do not find it important for them to test for HIV.
“Over 40 percent of Batswana do not know their HIV status, they therefore cannot access HIV programs readily available to them,” Koko said.
Also cited as reasons for most people not testing for HIV are ignorance, lack of interest in the subject as well as denial.
