To rely on results from HIV/AIDS self-test kit without the conventional confirmatory test in an approved government facility is not fool-proof to determine the status of any pregnant mother and prevent transmission of HIV to an unborn child.
National Programme Coordinator Prevention of Mother to Child Transmission of HIV (PMTCT), Dr Olugbenga Ijaodola says in an interview with Healthstyleplus ahead of the 2021 World AIDS Day (WAD) that the result from the self-test kit is insufficient to prove the HIV status of any pregnant woman.
According to Ijaodola, the National strategic plan on PMTCT provides that 95% of all pregnant women in the country who attend antenatal clinics in line with the policy, test for HIV to know their accurate status,
“Any HIV+ mother is put on antiretroviral drugs; which help to suppress viral loads of the infection and protect the child from infection at birth”, Ijaodola told Healthstyleplus.
The WAD has the theme: “End Inequalities. End AIDS. End pandemics” which according to United Nations on AIDS is a deliberate call on world leaders to end inequalities that drive AIDS and other pandemics such as covid-19 and remove barriers to treatment.
From the national strategic plan, 95% of HIV positive pregnant and breastfeeding mothers are to receive antiretroviral therapy, and 95% of HIV exposed infants receive antiretroviral prophylaxis due to unexpected exposure.
With this, says Ijaodola it would be possible to achieve placing 95% of HIV exposed infants on early infant diagnosis within 6-8 weeks of their births.
The idea is to have every HIV+ mother give birth to an HIV- negative baby and invariably, the country reaches a zero population of HIV by 2030 he explains.
Challenges Of HIV Testing
“At the moment, only a third of all pregnant women attend antenatal clinics and a third of those who test positive receive the antiretroviral”, says Ijaodola during a UNICEF media dialogue on Prevention of Mother to Child Transmission of HIV held for Journalists Against Prevention of HIV Infections in Nigeria (JAPIN) in Calabar, Cross Rivers State.
The inability to achieve full antiretroviral coverage for all pregnant women in Nigeria especially during the covid-19 period of 2020 states UNICEF in its 2021 data has resulted in an increase in the number of HIV+ children,
From the UNICEF’s HIV and AIDS Global Snapshot in 2020, every 30 minutes, one Nigerian child had HIV infection with a total of 20,695 children aged 0-9 years newly infected.
Unfortunately too, three of every 10 AIDS-related death in the country in the same year 2020, occurred in children, notes UNICEF.
Alarmingly, only about 3.5 per cent of the 1,629,427 Nigerians that is, about 30,050 people on antiretroviral treatment (ART) are children and this number notes UNICEF, reveals a big treatment gap.
The data also reveals that about 83,000 pregnant women in Nigeria are HIV positive with 44 per cent, 36,520 of them on ART thus fuelling mother-to-child transmission of HIV.
Speaking on the challenge of getting pregnant women into the national treatment plan, Ijaodola notes, “This is due to low antenatal care attendance by pregnant women, preference for community and home delivery, that 60% of pregnant women choose private facility over public due to claim of user fees demand.
The National Coordinator regrets that many states do not provide adequate funds for HIV activities especially to encourage pregnant women to visit facilities after use of self-test kit
He says, the challenge, therefore, is how to find positive pregnant women and refer them to the clinics for antenatal.
“The home self-test kit is not foolproof and every positive pregnant woman must enlist into the treatment programme once the confirmatory test is done”
Ijaodola observes that what happens in some cases is that pregnant women rely on the results of the self-test kit alone which is not foolproof.
“The Self-test kit does not replace the laboratory confirmatory test which is a more accurate method of testing” the Programme Coordinator points out.
“It is very important to get every positive pregnant woman into the facilities for optimal use of the conventional test kit which gives the accurate result “, he notes.
He adds that the federal government introduced the self-test kit to assist pregnant women and others in self-testing at home “but whatever the result, every woman must still show up for antenatal because, Self-test kit is not foolproof, he warned.
Nigeria HIV/AIDS Data:
In 2020, 20,695 children aged 0-9 years infected with HIV
130,000 children are living with HIV in Nigeria
6,479 adolescents aged 10-19 infected with HIV in 2020.
4,904 adolescent girl infected with HIV, compared with 1,575 adolescent boys.
14,998 children and adolescents died from AIDS-related causes: 12,386 aged 0-9 years and 2,612 aged 10-19espectively