Argentina: New report is evidence of the need for comprehensive HIV vertical transmission prevention policies

A TMAP (Treatment Monitoring and Advocacy Project) study conducted in Argentina and five other countries has shown efforts must be urgently increased if the universal goal of reducing vertical transmission in half and the goal of universal access to treatment and health services for women and child are to be met. The study also described gaps in HIV vertical transmission prevention programs in Argentina which are causing the rate of HIV infections to increase each year.

By: Lorena Di Giano

This recently published study states that 1500 new HIV cases in children younger than 14 years were reported in Argentina from 2001 to 2007, and most of these were attributed to vertical transmission.

And this in spite of national legislation on the books (#25543) which mandates all pregnant women are offered an HIV detection test. Nevertheless, the rate of women who were not tested before giving birth in some areas of the country is higher than 30%.

One of the greatest challenges facing vertical transmission prevention is many pregnant women do not visit health centers until relatively late in their terms. Likewise, most new infections in babies and children come about because women are not sufficiently informed and advised on HIV and AIDS, sexual and reproductive rights, and family planning.  

One thing that will help is for public policy to shift more attention to women’s health since most health care professionals emphasize preventing transmission to babies, while a woman’s right to HIV/ AIDS and sexual and reproductive rights information is completely forgotten, thereby hindering her ability to care for herself. 

The report highlights several obstacles to accessing vertical transmission prevention services in Argentina, such as:

·        There are no precise HIV prevention strategies that use the gender specific approach and that are for women of reproductive age.

·        Sometimes, women living with HIV do not have access to contraceptives or other materials that may assist them in taking greater control over their reproductive lives.

·        Many health workers are incapable or have not been properly trained to counsel women and to offer an HIV test.

·        Women living with HIV simply do not use health services because they are stigmatized and discriminated against.

·        The expansion of prevention of vertical transmission strategies has not been accompanied or followed by an increase in human resources. This means that existing health workers have far more duties and responsibilities, thereby compromising their capacity to provide thorough and appropriate care and services in many instances.

·    Treatment adherence is not universal, so more energy should be invested in creating and promoting programs that focus on treatment literacy and adherence, as well as on reinforcing psychological and social support offered during pregnancy.

According to the report, the most urgent actions are the following:

• National and local health authorities should work together and in partnership with civil society—including people living with HIV – to (1) identify factors that increase women’s and children’s vulnerability to HIV infection, (2) develop gender-based HIV/AIDS prevention programs that focus on the specific risk factors and needs of women of reproductive age, and (3) include sexual and reproductive health care and family planning as essential interventions for HIV prevention, care and treatment.
• In partnership with civil society and with the support of global agencies, the MoH should work with other ministries (at the national and local level) to develop human capacity at all levels through training in order to (1) reduce HIV related stigma and discrimination, (2) ensure compliance with the principles of informed consent and confidentiality, (3) improve HIV/ AIDS information and counseling quality, (4) enhance coordination between HIV/AIDS services and anti-violence referral services, and (5) promote treatment literacy among women and children living with HIV.

The Argentinean findings are part of the latest series of reports from the International Treatment Preparedness Coalition (ITPC Global) “Missing the Target – Failing Women, Failing Children: HIV, Vertical Transmission, and Women’s Health”. You can access it at: www.aidstreatmentaccess.org.

If you wish to read the entire Argentina report in spanish, click here:

http://www.observatoriolatino.org/upload_arch/Fallando_a_la_Meta_Transmision_Vertical.pdf

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