Despite efforts to eliminate mother-to-child transmission of HIV, the Uganda AIDS Commission (UAC) reveals that a significant number of mothers are still contracting the virus during pregnancy and breastfeeding, passing it on to their babies.
Dr. Daniel Byamukama, who heads HIV prevention at UAC, stated that an assessment has shown that the majority of those newly infected are young mothers, which undermines their efforts to end mother-to-child transmission.
He noted that while some districts are recording zero infections in babies, in others, five percent of mothers continue to transmit the virus to their babies. More than 80% of these mothers are women between the ages of 15 and 24.
Byamukama explained that since 2008, there has been a significant reduction in mother-to-child transmission of HIV due to the adoption of an innovation dubbed Option B Plus, where all HIV-positive pregnant mothers are immediately enrolled in treatment.
However, he highlighted a new challenge: mothers who are HIV-negative at the start of antenatal care but later contract the virus during pregnancy or breastfeeding. These mothers are often missed because many health facilities do not conduct HIV testing during every antenatal visit.
Commenting on these findings, Trevor Emojel, the Country Youth Representative at AHF Uganda Cares, expressed concern that Uganda is still facing challenges in preventing mother-to-child transmission despite being a leader in research aimed at reducing infections in children from the current five percent to zero.
Uganda played a key role in early research to prevent mother-to-child transmission of HIV. In 2000, the country introduced a protocol where HIV-positive mothers were given a dose of the antiretroviral drug Nevirapine during labor to reduce the risk of passing the virus to their babies.
Emojel noted that existing strategies have not been fully utilized because young mothers living with HIV often face significant stigma, which discourages them from taking medication. Additionally, HIV-negative young women often lack the agency to negotiate safe practices, such as condom use, leaving them vulnerable to infection.
Addressing stigma, Sylvia Pimer, a Youth Officer in the Ministry of Gender, Labor, and Social Development, attributed the issue to moral decline. She argued that despite widespread availability of information and prevention options, some young women engage in risky sexual behavior and rely on Post-Exposure Prophylaxis (PEP) as a fallback.
To address the issue of young women transmitting HIV to their babies, Byamukama emphasized the importance of involving men in prevention efforts. He explained that research indicates interventions targeting only young women are insufficient. “Interventions that exclusively target young women without involving men will not work, no matter how empowered or resourceful a young woman might be,” he said.
