The SA National Aids Council (Sanac) has reiterated the importance of at least 95% of children infected with HIV being tested and “linked to treatment and care” amid concerns over the rise in infection rates among infants.
Tshwane health officials said that between January and June this year, 232 babies in Gauteng tested positive for HIV, with 39 of them being from Tshwane – and although this was a slight reduction from previously, it was still a concern.
The marginal decline (for Tshwane) from 211 in the previous six months (July to December 2023) where Tshwane accounted for 43 cases, reflected the trend “of HIV-positive mothers defaulting on their ARV treatment during breastfeeding, pregnant mothers not having access or reporting late for antenatal care at clinics, and breastfeeding mothers who tested HIV-negative during pregnancy (later on) contracting HIV and transmitting it to the baby”, they said.
“It's getting better now, but we started from a point where things were really bad, and we (had) dropped the ball in terms of making sure children are not infected by HIV, especially post-natally and during the breastfeeding period,” Sanac’s technical lead for social and structural drivers of HIV, TB and STIs, Nozuko Majola, told TimesLIVE.
“At birth, we are doing fairly well because the numbers are showing that children are tested. The PCR (test) coverage is quite high … 98% of the live births are tested. So at that point, we are doing ok. Then at six weeks, we drop because we don’t know when children do seroconvert (so at that stage) we test about 87% during immunisation. So there are many missed opportunities because of the fragmented healthcare services provided to children.”
Seroconversion refers to a period during which the body begins producing detectable levels of HIV antibodies.
Majola said that when a baby goes for immunisation, it was usually administered by a different nurse, who would not necessarily test for HIV.
Between 2012 and 2015, South Africa recorded 0.2% HIV infections among babies as pregnant HIV mothers were put on ARVs immediately after testing. This changed when healthcare officials missed out on taking crucial steps after birth.
She said that while new guidelines to prevent vertical transmission were published in 2023, this was a revision of previous guidelines introduced over the years and were an improvement “based on the science presented to us”.
Since then, healthcare providers have been able to track infections better and ensure more children are placed on treatment.
This treatment, dolutegravir (DTG), is a transition from the old method, which was found to be unpalatable for babies and thus difficult for parents to administer.
“We are still tracking the data and if we look at the transition to DTG, as per the data from March 2024, our target was 63% in terms of transitioning or the uptake of DTG for children with HIV, nine years and below. In March, we … reached that target. So there is an improvement.
“The intention is to ensure 95% of all infected children are tested. So we need to find them. Currently we are standing at 82%. We need to make sure we link all of them to treatment and care,” she said.
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