People living openly with HIV in Mzansi are working to dismantle the stigma, spreading the message that it is not a death sentence. Despite these efforts, a recent SABC report disclosed that 232 babies in Gauteng were diagnosed with HIV in the first half of this year, with almost 40 cases occurring in Tshwane. This highlights a significant gap in mothers’ knowledge about how to protect their babies from HIV.
‘I have HIV-negative babies’
Mpho Mbeki-Ntoni is an HIV ambassador from Butterworth, in the Eastern Cape and has been living with HIV for 16 years.
She tells Health For Mzansi that she started protecting her unborn babies as soon as she learned she was pregnant and received valuable information during antenatal classes about the prevention of mother-to-child transmission.
“My journey with managing HIV during pregnancy was positive because I began my antenatal visits early. This made it safer for me to deliver HIV-negative babies, as my viral load was monitored.”
She adds, “I adhered to my ARVs and was well-informed about the precautions I needed to take to protect my baby.”
Mbeki-Ntoni shares that she was introduced to Nevirapine early in her pregnancy and was guided on what to do after giving birth.
“A support system is crucial for a pregnant woman living with HIV, as a lack of support and knowledge can increase the risk of transmitting the virus.”
Mpho Mbeki-Ntoni
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A scary journey
For Thulani Totyi from Gqeberha in the Eastern Cape, a couple of hours before her caesarean section, she had a conversation with a nurse about exclusively breastfeeding.
“At this point, I almost gave up on following my gynaecologist’s advice not to exclusively breastfeed because it seemed too risky.”
Totyi says the nurse sat down with her and reassured her that exclusively breastfeeding would be safe for her child since they would be taking Nevirapine for six weeks.
“I am glad I listened to the nurse, as it turned out to be a beautiful experience for 4.5 months.”
Totyi shares with Health For Mzansi that she was diagnosed with HIV on 5 July 2014, and gave birth in November of the same year. The support and guidance from her doctor, who recommended starting ARVs immediately to suppress the viral load, ensured that it would be suppressed by the time she gave birth.
“By eating healthy and staying stress-free, I had a healthy pregnancy with no complications, as my focus was my child’s safety.”
Thulani Totyi
She adds that the guidance from nurses through antenatal and postnatal classes was crucial in helping her give birth to an HIV-negative baby.
Mother-to-child HIV safety
Dr Mxolisi Xulu from Themba Hospital in Kabokweni, Mpumalanga, emphasises that the key to preventing mother-to-child transmission of HIV begins even before conception. He notes that while this is the safest standard practice, some pregnancies are unplanned and cannot follow these guidelines.
Xulu explains that during pregnancy, various tests are conducted to monitor the health of both the mother and the baby. These tests include screenings for hypertension, HIV, syphilis, and rhesus factor. He underscores the importance of antenatal care for a healthy pregnancy.
“For HIV-positive mothers, we aim to keep the viral load below 50 to protect the baby,” says Xulu.
“We need to ensure that the mother is on adequate antiretroviral therapy. If the viral load is suppressed, we are satisfied, and we continue to monitor the mother until delivery.”
He further explains that all HIV-positive patients undergo the GeneXpert test to rule out tuberculosis if they show symptoms.
“If TB results are positive, we treat the TB first for a couple of months, and then we start the antiretroviral therapy.”
Dr MXolisi Xulu
From antenatal to postnatal care
Xulu explains that for women newly diagnosed with HIV during pregnancy, as well as those with suppressed HIV, a delivery viral load test is performed.
“We do the viral load test to determine if the baby is at high risk or low risk of HIV, so we can manage the baby accordingly,” he says.
He notes that viral load results can take time to return. If the results are unknown at delivery, all babies are classified as high risk.
“We give babies a birth PCR test. If any baby tests positive for HIV, we start treatment immediately. If the PCR is negative and the mother’s delivery viral load is unknown, the baby is classified as high risk and receives dual therapy with Zidovudine and Nevirapine.”
If the maternal viral load returns at less than 50, the baby is reclassified as low risk, Xulu explains.
“In this case, the baby will be on Nevirapine for six weeks. If the mother is formula feeding, six weeks of Nevirapine is sufficient.”
Dr Mxolisi Xulu
“If the mother is exclusively breastfeeding, Nevirapine continues until four weeks after breastfeeding stops.”
Xulu notes that if the mother decides to breastfeed for a year, the baby will take Nevirapine for the entire duration of breastfeeding and four weeks afterwards.
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