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Malawi, 1 December 2014: World Aids Day: AIDS-free generation starts with children

© UNICEF Malawi/2014
Nurse Midwife Technician, Rose Zgambo takes blood samples of Halen for an HIV test at Luzi Health Centre.

1 December 2014, LILONGWE, Malawi – On this World Aids Day, people worldwide unite in the fight against HIV. Malawi is leading in this fight, and has already achieved a sharp decline of 67 per cent less new HIV infections between 2009 and 2013. However, there are still 1 million people in Malawi who are living with HIV, an estimated 170,000 of them are younger than 14. And although the HIV prevalence has gone down in the general population, infection rates have increased among adolescents, especially girls. UNICEF Malawi, together with the Malawi Government and NGOs, is working to also reach these vulnerable adolescents.

Malawi’s achievement in reducing new infections can be contributed to the option B+ treatment, which the country pioneered in 2011 to prevent mother-to-child transmission (PMTCT) of HIV. Under Option B+, all pregnant women who are found to be HIV positive start antiretroviral therapy (ART) as soon as possible during pregnancy, and remain on ART for life. Currently, 76 per cent of HIV infected pregnant women are on ART to reduce the risk of mother-to-child transmission, and 615 sites provide PMTCT services.

PMTCT services can turn a life of despair into a life of hope, as the story of Edward and Witness shows. They live in Luzi, an area bordering Rumphi district, about 400 kilometres north from the capital Lilongwe. After being informed of her positive HIV status, Witness was shocked. It was not easy for her to reveal the news to her husband, but when she finally found the courage to do so, he reacted surprisingly well. The next day already, Edward went to the hospital to find out his own status. At the Rumphi District Hospital, the same health facility where his wife was tested, he received the same news: Edward’s test turned out to be positive as well.

Together, the two started accessing the life prolonging ARV treatment and a year after they found out about their HIV status, Witness gave birth to a healthy baby girl, called Desire. “We wanted to show our desire to continue enjoying life despite our status,” Edward smiled. Through the PMTCT programme, the baby was born HIV negative. Subsequent tests confirmed the same and Desire grew up to a healthy happy child.

“We realised through this programme, we can freely have children without worrying about transmitting the virus to the child,” said Witness. This encouraged her to have more children, and thanks to the antiretroviral treatment, she gave birth to baby twins, called Helen and Halen. Six weeks after these little babies were born, they had their first HIV test, which proved they were free of the virus. “We were excited with the news because we still had the fear that, maybe our children had been infected,” said Edward.

© UNICEF Malawi/2014
Zimbabwean musician and UNICEF Goodwill Ambassador Oliver Mtukudzi visits the room where HTC and STI screening will be provided and condoms will be distributed.

With time, the twins have grown up to healthy children who are already taking their first wobbly steps and who are laughing with joy while playing with their big sister. One week after their first birthday, their parents took them back to the health centre for the second HIV test. Just like the first one, this test brought good results: the children were again confirmed free of the virus. “For the second test, we went there as formality but we were not afraid of anything. We were convinced our children are free of the virus,” Witness added. The couple will return to Luzi Health Centre two months before Halen and Helen reach two years for the last HIV/Aids test, which will provide final results of the status of the children. Rose Zgambo, the Nurse Midwife Technician and HIV Counsellor at the Heath Centre, is pleased with the results. “The life of this couple and the twins, including their first born, is a clear testimony that PMTCT works wonders if well administered,” she smiles.

Thanks to the Option B+ approach, the percentage of infected infants born to HIV infected mothers is declining (from 16.5 per cent in 2008 to 13.8 per cent in 2010). However, for an AIDS-free generation to become reality, adolescents – especially girls – have to be reached as well. An estimated 49,000 adolescent girls and 42,000 adolescent boys are living with HIV now.

The expansion of reproductive health services for adolescents could tackle the high prevalence of HIV among these young adults. As they often don’t go to health centres, outreach service delivery is an effective way to reach an increased number of adolescents in hard to reach areas. UNICEF Malawi, with support from the Germany, through GIZ, is supporting the Ministry of Health (MoH) to implement a 4-year project to scale up adolescents’ access to quality information and utilization of HIV prevention, treatment, care and support in 10 districts. Nearly 70 per cent of clients accessing HIV testing provided through these outreach service delivery are adolescents, compared to 12 per cent accessing the services at static facilities. Moreover, nearly 52 per cent of adolescents accessing HTC during outreach service delivery are males and 46 per cent are non-pregnant females – typically groups that are difficult to reach.

To reach out to adolescents in area 25 in Lilongwe, UNICEF Malawi organised an event at the end of August 2014. Star of the day was Zimbabwean musician and UNICEF Goodwill Ambassador Oliver Mtukudzi, who attracted many young people with his performance. In partnership with Banja La Mtsogolo (BLM), an organisation providing sexual and reproductive health services, the attending youth was encouraged to get tested and know their HIV status. There was also family planning and STI screening provided. Moreover, condoms and information were distributed. A necessary measure, as not even half of all young people between 15 and 24 years correctly identify ways of preventing the sexual transmission of HIV.

This World AIDS Day is a great opportunity to raise awareness about HIV/AIDS, an issue that is affecting everybody in everyday life. Knowing your HIV status, whether positive or negative, is key to preventing the spread of HIV. Oliver Mtkududzi affirms: “If we are to have an HIV-free generation, it has to start with this generation. We have to start with ourselves.”



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