What Does a Pair of Gloves Have to Do With Achieving an HIV/AIDS-Free Generation? Turns Out, A Lot.
Fatuma* is a breastfeeding mother who walks into a health center located in a peri-urban town to receive services at a Prevention of Mother-to-Child Transmission (PMTCT) of HIV/AIDS clinic on a Tuesday morning. After her consultation, she is directed to the laboratory to take her baby’s blood sample for a DNA polymerase chain reaction (PCR) test. There she is informed that there are no rubber gloves at the laboratory. The laboratory technician asks Fatuma to purchase a pair from any pharmacy outside the health center before her blood sample can be taken. The gloves outside the health center cost approximately 1000–2000 UGX (0.281–0.56 USD). Upon leaving the laboratory, she comes back to ask the peer mothers supporting at the health center for a solution because she does not have funds to purchase the gloves. She is provided with an option of taking the drug prescriptions and returning for the laboratory test whenever she can afford to purchase gloves. This is one of many scenarios pregnant and breastfeeding women face when they arrive at the health center only to return to their homes without taking the recommended laboratory tests by the clinicians because of their inability to afford a pair of gloves.
Mother-to-Child Transmission (MTCT) of HIV/AIDS is one of the largest sources of HIV infection in children below the age of 14. In 2019, only 6 in 10 HIV-exposed babies were tested for HIV within their first two months of life. At this particular health center, there are missed opportunities for testing for HIV/AIDS among pregnant women and newly born infants due to a lack of supplies, such as rubber gloves. This implies the status of the babies and mothers shall be unknown to them, therefore, increasing the chances of HIV/AIDS infection as a result of missing the core PMTCT services.
Early diagnosis of HIV allows healthcare providers to offer optimal care and treatment of HIV-infected children, supports decision-making on infant feeding, and avoids unneeded tension in mothers and families about the baby’s HIV status. PMTCT programs are designed with an aim of improving maternal health for women living with or at risk of acquiring HIV/AIDS and these programs help prevent their infants from acquiring HIV. These services ought to be offered before conception, throughout pregnancy, during labor, and breastfeeding. Additionally, the services include early infant diagnosis using the DNA PCR tests from 6 weeks after birth through 18 months. A DNA PCR test is among the technologies available for diagnosis for HIV in infants with the view of early commencement of treatment for infected infants.
A pregnant woman living with HIV can pass on the virus to her baby during pregnancy, at childbirth, and through breastfeeding. For one to know their status, they would need to get tested for HIV during antenatal care and proceed to take antiretroviral treatment correctly (ART) to eliminate chances of passing the virus to the baby. Globally, 53% of all people living with HIV in 2020 were women. Additionally, girls accounted for 50% of all new infections. About 6.1 million people did not know that they were living with HIV in 2020. 1.7 million children from 0–14 years are living with HIV.
Pregnant and breastfeeding women who were not in a position to afford gloves had a higher chance of not taking an HIV/AIDS test for themselves or their babies. Imagine the proportion of pregnant or breastfeeding women who do not currently know their HIV/AIDS status or that of their babies. What impact does this have?
I call upon advocates, governments, health teams, and other stakeholders gearing towards an HIV/AIDS-free generation to lobby for the provision of more gloves to health facilities with PMTCT clinics––most especially among economically underprivileged communities.
*Names have been changed for anonymity.
Catherine Guntesse Naluggya is a 2020–2021 Global Health Corps fellow and Knowledge Management Officer at Elizabeth Glaser Pediatric AIDS Foundation.
Global Health Corps (GHC) is a leadership development organization building the next generation of health equity leaders around the world. All GHC fellows, partners, and supporters are united in a common belief: health is a human right. There is a role for everyone in the movement for health equity. To learn more, visit our website and connect with us on Twitter/Instagram/Facebook.
