The PMTCT progamme aims to reduce the risk of transmission of HIV from the mother to her baby.

• What is the PMTCT programme?
• Infant feeding
• The baby's health and development
• The mother's health and development
• Getting Nevirapine
• Useful contacts

When a mother goes to the clinic, Midwife Obstetric Unit or hospital for her first antenatal visit, she is given counselling and is asked if she wants to take an HIV test. The results are confidential, which means that only the counsellor and healthcare workers looking after the mother will discuss the results.

If the mother takes the test and is found to be HIV positive, she will have the option to join the PMTCT programme free of charge. As part of the programme she will be given Nevirapine and Zidovudine, anti-HIV medicine.

The mother must take the Zidovudine from 34 weeks pregnancy, and will be given Nevirapine when she goes into labour and reports at the hospital or MOU. These medicines in syrup form, will also be given to the baby within 6-72 hours of birth.

It's important to note that:

• The medication only reduces the chance of passing the virus in the mother's body to the baby during delivery. Transmission during delivery is the most common factor, accounting for 60-85% of transmissions of the virus from the mother to her baby.
• Babies who get the virus while the mother is pregnant or as a result of breastfeeding will not be protected by the antiretroviral medicine.
• The medication is only used to try and protect the baby. It is not going to cure the mother of HIV.

Any mother who wishes to know her HIV status may access HIV testing and treatment through the PMTCT program at any antenatal facility throughout the Western Cape.

Counselling and advice on infant feeding for HIV-positive mothers is available. Mothers are given a choice to either exclusively breastfeed for four to six months or exclusively formula feed. Exclusive breastfeeding means that the baby must only be given breast milk, no tea, no water and no juice. This reduces the chance of the virus in the breast milk being passed on to the baby. Those mothers choosing to formula feed will get free milk powder for six months. They will get two tins of milk powder on discharge after delivery and will also get eight tins per month at the local baby clinic.

The mother must go regularly to the post-natal clinic to have the baby weighed, to get immunisations, to be given milk powder and to get Co-trimoxazole, medicine to prevent pneumonia.

Babies are tested for the HIV at 14 weeks when they report for the 3rd immunisation visit. If negative, the baby does not need Co-trimoxazole any longer. If the baby tests positive then they must continue with Co-trimoxazole. If the baby is positive, it will need special care throughout its life.

HIV can live for a long time (3-10) years in the body whilst the mother feels healthy and well. For this reason mothers are encouraged to go to the clinic regularly to get medicine for opportunistic infections to keep healthy for longer. She is encouraged to use condoms every time she has sex so that she can protect herself and her partner from contracting the virus, or from getting more of the virus if both partners are HIV positive.

The mother will also be given counselling about contraception options for after the birth. The health worker will encourage the mother to tell the father of the baby that she is HIV positive so that he can also be tested. This can happen with the aid of the counsellor or health worker. It is important for the mother to join a group that will support her and give her information on eating nutritiously and how to look after herself and the baby. Formal support groups are available and can be contacted through the local clinic.

Go to a Midwife Obstetric Unit in urban areas and fixed or mobile clinics and primary health care centres. If you are referred up the line you will be sent to urban or rural regional hospitals or tertiary hospitals.

For more information please contact:

• Metro Region: Ms J Arendse 021 918 1545
• S Cape/Karoo: Ms I Reynierse 044 874 217 / 044 803 2700
• Boland/Overberg: Mr J Kruger 023 348 1424
• West Coast/Winelands: Ms A Herling 022 487 9332
• Head office: 021 483 5751

First-time visitors to the clinic/secondary or tertiary hospital will be asked to fill out a form and a folder will be opened for the patient. Bring your ID book. A referral letter from the clinic is required when visiting a hospital.

• Aids Training and Information Centre ( ATIC): tel 021 797 3327, fax 021 797 3356
• National Association of People Living with HIV/Aids (Napwa): tel 021 424 1106
• Treatment Action Campaign (TAC): tel 021 788 3507, fax 021 788 3726
• Aids Law Project (ALP): tel 011 356 4100, fax 011 339 4311
• Gender Advocacy Project (GAP): tel 021 465 0197
• Planned Parenthood Association (PPA) Western Cape: tel 021 448 7312, email: admin@ppawc.co.za
• Reproductive Rights Alliance (RRA): tel 011 403 2101, email: rradmin@sn.apc.org or rracoord@sn.apc.org.