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Zambia PMTCT Training Package. PMTCT Prevention of Mother-to-Child Transmission of HIV. Module 1: Introduction to HIV and AIDS and PMTCT. Learning Objectives. By the end of this module the participants will be able to: Define key terms relevant to HIV and AIDS and PMTCT

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Pmtct prevention of mother to child transmission of hiv

PMTCTPrevention of Mother-to-Child Transmission of HIV

Module 1: Introduction

to HIV and AIDS and PMTCT

Learning objectives
Learning Objectives

By the end of this module the participants will be able to:

  • Define key terms relevant to HIV and AIDS and PMTCT

  • Discuss the epidemiology of HIV and AIDS globally and in Zambia

  • Describe the four prongs of PMTCT

  • Advocate for the support and implementation of PMTCT programmes

  • Discuss the modes of transmission of HIV from mothers to their children


  • PMTCT is critical in the fight against HIV/AIDS.

  • Adult prevalence rate in Zambia is 14.3%.

  • Among women aged 15-49, the HIV prevalence rate is 16.4%

  • Approximately 80,000 infants born annually are HIV exposed as their mothers are HIV

  • The HIV prevalence in urban areas is more than twice as high as in rural areas (23% and 11%) respectively

Introduction contd
Introduction contd.

  • MTCT can occur during pregnancy, labour and delivery, and breastfeeding

  • Without interventions 25% - 45% of the children born to HIV-infected mothers will get infected with HIV.

  • Evidence-based practices exist that can reduce the chances of infection for children of HIV positive mothers

Epidemiology of hiv and aids globally
Epidemiology of HIV and AIDS globally

  • People living with HIV in 2010 was 33.3 million (compared to 39.5 million in 2006).

  • The number of new infections has fallen by 19%.

  • In 33 countries, HIV incidence has fallen by more than 25% between 2001 and 2009.

  • The biggest epidemics in Sub-Saharan Africa including Zambia have either stabilised or showed decline.

Epidemiology of hiv and aids in sub saharan africa
Epidemiology of HIV and AIDS in Sub-Saharan Africa

  • The most seriously affected region.

  • The rate of new HIV infections has decreased (incidence), the total number (prevalence) of people living with HIV continues to rise

  • Sub-Saharan Africa has more women than men living with HIV.

  • Globally 1.8 million deaths of which 1.3 million deaths (72%) are in Sub Saharan Africa

New hiv infections among children
New HIV infections among children.

  • New HIV infections among children younger than 15 years have declined

  • 32% fewer children were newly infected between 2004 and 2009(130,000 vs 190,000)

  • In 2009, 90,000 children died due to HIV as compared to 120,000 in 2004


  • Slightly more than half of all people living with HIV are women and girls.

  • In sub-Saharan Africa, more women than men are living with HIV, and young women aged 15–24 years are as much as eight times more likely than men to be HIV positive.

Hiv in zambia
HIV in Zambia

  • Over 1.1 million people are estimated to be living with HIV and AIDS

  • HIV incidence has reduced by half since 1990, from 3.2 % to 1.6 %

  • 80,000 infants born annually to HIV positive mothers

  • 95 % of women attending antenatal care services (ANC) are tested for HIV

Hiv in zambia1
HIV in Zambia

  • Pregnancy care is a key gateway to the delivery of integrated services to families

  • Pregnant and lactating women are at high risk for HIV infection

  • 2-3% will acquire HIV infection during each pregnancy.

Hiv in zambia2
HIV in Zambia

  • 95% of pregnant women are tested for HIV in ANC clinics

  • Male partner testing has been shown to work in Luapula and Southern provinces (up to 70% in some cases)

  • More than 95% of the of ANC attendees are tested for HIV and access to ARVs is more than 85%.

Hiv in zambia3
HIV in Zambia

  • In the general adult population, only 23.4% are tested, and only 10% of male partners are tested.

  • 11% of married couples are discordant of HIV.

Mtct of hiv

  • PMTCT programmes have shown positive results in many countries. Results as low as 2% transmission rates have been reached.

  • In Zambia, positive trends have also been demonstrated.

  • For the Zambian programme to continue having impact services need to be scaled-up to all Maternal Neonatal Child Health (MNCH) services in the country.

Mtct of hiv1

Scaling up involves use of four key strategies, or prongs:

  • Prevention of primary infection

  • Prevention of unintended pregnancy in HIV infected women

  • Interventions aimed at the prevention of mother to child transmission

  • Linkages to treatment (ARVs), care and support of infected families


  • Transmission of HIV at six weeks from Mother to Child Transmission is at 6.5%

  • With no PMTCT interventions, the transmission of MTCT is 20.9%

  • HIV transmission increases with time to about 18% by age 18 months for breastfed babies

Four pillars of pmtct
Four Pillars of PMTCT


Uninfected Parents to be

Progression of HIV/AIDS

I. Primary prevention of HIV

HIV infected


II. Prevention of unintended pregnancy

Pregnant HIV infected woman

III. Prevention of MTCT

HIV infected infant

IV. Linkage to ARVs, Care and Support

Progression to AIDS

Advocate for the support and implementation of pmtct programmes
Advocate for the support and implementation of PMTCT programmes

  • Goals of PMTCT in Zambia

  • The goal of PMTCT in Zambia is to eliminate HIV transmission to children and keep their mothers alive

Pmtct objectives in line with elimination
PMTCT Objectives in line with Elimination programmes

  • To reduce the transmission of MTCT of HIV to less than 5% by 2015

  • To reduce the unmet need for family planning by 50% from the current levels of 27% by 2015

  • To provide ART to at least 95% of HIV positive children in need of treatment by 2015

Quality pmtct services
Quality PMTCT services programmes

  • Stop use of Single dose NVP and replace it with use of AZT/3TC and NVP

  • Increase access to CD4 count testing for all HIV positive pregnant women (in the absence of easy access to CD4, WHO criteria need to be used).

  • Improve universal access to early infant diagnosis of HIV

Quality pmtct services1
Quality PMTCT services programmes

  • Improve access for all HIV positive infants to ART

  • Improve access to ART for all eligible women.

  • Wholesome efforts at addressing all the four prongs of PMTCT

Modes of transmission
Modes of Transmission programmes

  • During pregnancy (5%-10%)

  • During labour and delivery (10%-20%)

  • During breastfeeding (0%-20%)

Thank you
Thank You! programmes

Any Questions?