A major obstacle to ending new infections is the lack of awareness and access to care in rural areas. Many pregnant women in these communities are unaware of their HIV status, leading to a high rate of MTCT. Dr. Agatha David, NIMR’s Coordinator of the Child and Adolescent HIV Programme, points out that factors such as late antenatal care registration, inadequate HIV testing in some private health facilities, and the preference for traditional birth attendants contribute to this issue. The data from the National Agency for the Control of AIDS (NACA) confirms this, showing a national MTCT rate of 22%, with some states having rates exceeding 25%.
To combat this, there is an urgent need to intensify campaigns and scale up awareness in even the most remote parts of the country. By ensuring pregnant women have access to facilities where they can be tested and, if positive, placed on antiretroviral therapy (ART), the burden of children born with HIV can be significantly reduced. NIMR’s own success in this area is a testament to the effectiveness of treatment, with the institute not having recorded a positive child birth in over six years due to effective ART.
Beyond pregnant women, adolescents and young adults represent another critical demographic in the fight against HIV. They have the worst treatment outcomes due to poor adherence to testing and treatment. Studies reveal that approximately 23% of young people have never been tested for HIV, and this age group accounts for 40% of all new infections.
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Dr. David emphasises that many young people who are diagnosed and enrolled in care fail to consistently take their medication. This poor adherence contributes to a high chain of transmission, making it a global concern. To address this, there needs to be an attitudinal change among this group, with a focus on strict adherence to ART to achieve viral suppression, halt disease progression, prevent drug resistance, and stop further transmission.
Achieving the UNAIDS 95-95-95 targets, where 95% of people with HIV know their status, 95% of those diagnosed are on treatment, and 95% of those on treatment achieve viral suppression, requires a multifaceted strategy. NIMR’s work, including a new outreach clinic for children in an orphanage and research into a novel Microbicides Gel for women, demonstrates a commitment to this goal.
