Bujumbura – “It is unacceptable that in 2024, a child will still be born with HIV,” says Novela Irakoze, a person living with HIV and committed to preventing mother-to-child transmission of HIV (PMTCT). “I was born with HIV and my goal is to protect children so they don’t have to go through what I went through.”
Novela is part of a group of women called Mentor Moms who support HIV-positive pregnant women so that they can follow appropriate treatment and protect their babies from the virus.
In 2020, Burundi, where 9% of the population is living with HIV, emerged as a leader in the fight against HIV in West and Central Africa, moving closer to the UNAIDS 90-90-90 targets. By that date, 89% of people living with HIV knew their status, 98% were on antiretroviral treatment, and 90% had achieved viral suppression.
Despite these advances, preventing mother-to-child transmission of HIV remains a significant challenge. Only 69% of HIV-positive pregnant women receive ARV treatment, compared to 95.4% of all people living with HIV. The rate of mother-to-child transmission of HIV remains above 12%, while the national objective is to reduce it to less than 2%.
“To successfully prevent transmission, it is essential to keep the mother-child pair in the cascade of care until the end of the HIV exposure period,” says Dr Denise Nkezimana, HIV, TB and Hepatitis Programme Manager at the WHO Burundi office. However, many women abandon treatment or miss testing appointments for their children, due to social stigma or lack of resources.
In response to these challenges, the Burundian government, in partnership with the World Health Organization (WHO), launched the Mamans Mentors pilot program, a peer education approach, in 2019. To date, 135 women have been trained in three provinces, with the ambition of rolling out this initiative nationwide.
“The Mamans Mentors are model mothers living with HIV, who support and raise awareness among their peers about screening and treatment. They also strengthen primary prevention of infection in hard-to-reach populations,” explains Dr. Aimé Ndayizeye, Director of the National AIDS Control Program (PNLS).
Mwanaidi Ndayishimiye, 30, discovered she was HIV positive during her first antenatal care (ANC). Pregnant with her first child, the news came as a profound shock. Under the stress, she had a bad fall and lost her baby. “It was very difficult to accept, as if the sky was falling on my head,” she says.
“The Mamans Mentors supported me during my second pregnancy. They educate us and offer us an important space to talk. It was beneficial,” says Mwanaidi, now the mother of a 13-month-old HIV-negative child who is doing well.
With the involvement of mentor mothers, by 2023, all HIV-positive pregnant women will have received ARV treatment.
The Mamans Mentors ensure that pregnant women regularly visit health centres to find out their HIV status and continue their treatment.
“We check the viral load at 3 months of pregnancy, then at 6 months to ensure that the woman gives birth with an undetectable viral load,” explains Triphonie Yamuremye, Head of the PMTCT care service at the Buyenzi community medicine center, in the commune of Bujumbura.
To scale up the success of the programme nationally, WHO is supporting the development of a guide for Mamans Mentors and is supporting Burundi to aim for certification of the triple elimination of mother-to-child transmission of HIV, syphilis and hepatitis B.
“During a community visit, we met a 24-year-old girl who was pregnant and in critical condition. We were worried that her baby was already infected,” recalls Maman Mentor Novela. “Thanks to our intervention, she and her child, who was born HIV-negative, are doing very well today. These are the victories we are fighting for, and we will not stop until Burundi is an HIV-free country.”
