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HIV: prevention of mother to child transmission expanded in Togo

© UNICEF/Togo/2008/Bonnaud
Like every day for the past 4 years, Amivi receives free ARV treatment and a medical follow-up for her daughter.

Lomé, Togo, 21 July 2009 - Amivi is 27 years old. She recently celebrated her daughter Yabo’s first birthday.

Amivi is HIV-positive. Today, like every other day for the past 4 years, she is going to a health center to receive free anti-retroviral treatment (ARV) and to receive a medical follow-up for her daughter.

Thanks to the support of UNICEF, Bè Hospital opened a care center for the prevention of mother-to-child transmission (PMTCT) in 2003.

During her pregnancy, Amivi benefited from free PMTCT treatment. But the young mother had to wait 18 months to know her daughter’s status for sure.

“The doctor told me that at the beginning of a baby’s life, it is the mother’s blood which is flowing in the baby’s veins. Then progressively the child produces its own blood and antibodies. When Yabo was 1, she tested positive to the HIV test. It was a disaster!” said Amivi before adding with a big smile

“Today, my daughter did the second test, the 18-month one, and she is negative! What a relief!”

In Togo, the national HIV/AIDS prevalence rate is 3.3% and 4.2% among pregnant women. While the HIV testing acceptance rate rose from 50% in 2005 to 74% in 2007 in existing PMTCT clinics, the proportion of HIV-positive pregnant women accessing HIV testing nationally remains low (about 20% in 2008).

Women’s awareness of mother-to-child transmission is poor and 4 out of 10 women are not aware that a treatment preventing mother-to-child transmission exists.

So they don’t automatically think about taking an HIV test when they get pregnant.

In order to increase access to PMTCT treatment, UNICEF has decided to support all 45 PMTCT care centers and to create 30 new PMTCT centers in 2009. 

Medicine for the poorest

Amivi is “shy”. “But I have to overcome my fear of speaking, because I don’t want my daughter to suffer as I do. My story is that of every woman in Africa.” she claims with eyes full of hope.

This young mother was only 20 when she met a man who gave her money in exchange for unprotected sex. “He was giving me as much as 1,000 CFA or 2,000 CFA -between 2 and 4 US$.

Then after some time, I started to get dizzy and feel nauseous. I was HIV-positive but I didn’t really know what it meant. And then, I realized I was pregnant”.

Amivi did not go to a doctor quickly. Like 6 out of 10 Togolese, she lives below the poverty line – on less than 2 US$ per day.

“Healthcare is too expensive and I could not afford a prenatal consultation. I gave birth to my son and breastfed him as I was advised to. Then he died after suffering from severe diarrhoea. At that moment I decided to accept my HIV status”.

© UNICEF/Togo/2008/Bonnaud
In the CRIPS health center next to the Bè laguna of Lomé, Doctor Aho (on the right) and his team prepare the distribution of ARV treatment.

Stigmatized then made responsible

At first, Amivi hid the fact that she was HIV positive, because she feared she would be stigmatized;

“Here, if people find out you have AIDS, they will not talk to you or share a meal with you. You will be alone and unwelcome in the community”.

Finally, following her uncle’s advice, Amivi agreed to seek treatment.

When she became pregnant the second time, she decided to speak up and “appeal to the future generations to take more care of themselves”.

“It is my responsibility to tell my story, in order to inform those willing to listen to me”. Nowadays Amivi speaks openly about being HIV-positive and gives advice on how to prevent HIV to her neighbours, her family and her friends. “As a mother, it is my duty to accept my status” she insists.

“If no one had informed me that prenatal consultations for HIV-positive people were free at Bè hospital, my daughter might already be dead” says Amivi.

A future without HIV/AIDS

Two years ago, she met Kossi, now her fiancé and Yabo’s father. The young man is a taxi-moto driver, like many other men in Lomé without a formal job.

“He never wanted to use condoms” complains Amivi. “I told him I was HIV-positive, but because I am not particularly skinny, he didn’t believe it!”

This reaction is evidence of the ongoing rumours and misinformation that circulate about HIV/AIDS;

“In Togo, men have a tendency to consider women healthy if they are well proportioned, just like me!” she explains.

“Now I know that my daughter is not infected by HIV, my dream would be to live in a house with my fiancé and become a real family!” says Amivi and adds “I am pregnant again and I hope that preventive treatment will work again and that my baby won’t be infected by HIV/AIDS”.

Thanks to UNICEF’s support to Bè Hospital, the future baby has a 95% chance of not being infected by HIV/AIDS.

A life can be saved with only 35 US$, the cost of ARV treatment during PMTCT. UNICEF aims to contribute to the scaling up of the national PMTCT programme through the creation of 100 new centers by 2012.

This means that by 2012, 80% of women, as opposed to the current 48, 6%, will be able to benefit from PMTCT services.

By Hadrien Bonnaud




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