Challenges of PMTCT and related HIV care in DR-Congo

The aim of our project is to document challenges encountered in implementing the PMTCT intervention in the DRC. In developing countries the challenges for PMTCT activities are many. We will focus on some of the major challenges (1) Low male involvement in PMTCT is the first component of our research. We conducted a study on this component in 2007, we analysed the data and our manuscript has been accepted for publication in the International Journal of STD and AIDS (2) Low follow up rates of the mother and infant couple. We will use the data obtained during a PMTCT program evaluation in two maternities in Kinshasa. We are currently analysing these data (3) Feasibility of safe exclusive breast feeding with continuous nevirapine prophylaxis for the HIV exposed infants. The latter study will take place at the maternities supported by the Kinshasa School of Public Health and the Elizabeth Glaser AIDS Pediatric Foundation. 25 maternities where the new WHO guidelines for PMTP are implemented will be part of the study (5 in Kinshasa) and 20 across the country. According to these guidelines, a) all the pregnant women eligible for HAART will be given HAART and their infant nevirapine daily for 6 weeks. b) The non-HAART eligible pregnant women will be given nevirapine prophylaxis according to the WHO guidelines option A. (mothers will receive AZT prophylaxis and their children nevirapine prophylaxis until 1 week after the breast feeding has finished). Infants will be followed for a period of 15 months and their outcome assessed.