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
• Useful Contacts

When a mother goes to the clinic, Midwife Obstetric Unit or hospital for her first antenatal visit, she receives routine counselling and voluntary testing. 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. If the mother tests HIV positive, a CD4 count and WHO staging will be done to determine the anti-retroviral management of the client during the antenatal period. A client with CD4 > 250 and WHO Stage 1-3 will receive:

1. Zidovudine from 28 weeks of pregnancy.
2. Nevirapine in labour.
3. Zidovudine three-hourly in labour. If the mother has a CD4 count <250 irrespective of WHO stage or WHO stage 4 she will be referred for HAART (Triple therapy).

On discharge, the baby will also receive Zidovudine and Nevirapine syrup within six to 72 hours after birth. The babies will either receive Zidovudine for one week or one month depending if the mother received adequate anti-retroviral treatment antenatally.

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 six months or exclusively formula feed. Exclusive breastfeeding means that the baby must only be given breast milk, no tea, no water, no juice or solids. This reduces the chance of the virus in the breast milk being passed on to the baby. Those mothers choosing to formula feed will be provided with formula milk until the baby is six months old. They will get two tins of formula milk on discharge after delivery and thereafter ten tins per month at the baby follow-up facility.

The mother should arrive with the baby within one to two weeks after birth at the nearest baby follow-up clinic, thereafter every two weeks for the following: monitoring of babies weight, immunisation, co-trimoxazole (to prevent pneumonia), checks on feeding practices and if the mother choose formula feeding, to provide the formula milk to the mother.

The baby will receive an HIV test at six weeks, which coincides with the immunisation visit and Co-trimoxazole administration. If negative, the baby does not need Co-trimoxazole any longer. If the baby tests positive then they must continue with Co-trimoxazole, these babies must be referred for clinical assessment and started on HAART

HIV can live for a long time (three to ten 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.

For more information please contact:

• Head office: Ms P Pieters
  Tel: 021 483 3359
• Metro: Mitchell's Plain and Klipfontein Substructure: Ms N Peton
• Tygerberg and Northern Substructure: Ms R Perrang
• Southern and Western Substructure: Ms L Appolis
• Khayelitsha and Eastern Substructure: Mr G Matiso
• Eden: Ms S Kruger
  Tel: 044 803 2749
• Cape Winelands: Dr Lunnon
  Tel: 023 348 8118
• Overberg: Ms E Hans
  Tel: 028 212 1070
• West Coast: Ms W Kamfer
  Tel: 022 487 9332
• Central Karoo: Ms M Lottering
  Tel: 023 414 8200

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 Counselling Centre ( ATICC):
  Tel: 021 763 5320/1/2/3
  Fax: 021 797 3356
• National Association of People Living with HIV/AIDS (NAPWA)
  Tel: 021 425 6860
  Fax: 021 421 9952
• Treatment Action Campaign (TAC)
  Tel: 021 447 2593
  Fax: 021 448 0382
• AIDS Law Project (ALP)
  Tel: 011 356 4100
  Fax: 011 339 4311
  E-mail: info@alp.org.za
• Gender Advocacy Project (GAP)
  Tel: 021 423 7088
  Fax: 021 424 5645
• Planned Parenthood Association of South Africa (PPASA)
  Tel: 021 448 7312
  Fax: 021 448 7320
  E-mail: clairissa@ppawc.co.za
• Reproductive Rights Alliance (RRA)