South Africa's Fight Against HIV: Progress and Challenges

South Africa has been actively working to stop HIV from spreading from mothers to their babies. The country has made big strides, but there are still some issues to tackle. First, let's talk about the good news. South Africa has one of the best policies in the world to prevent HIV transmission from mother to child. Thanks to this, the country is close to reaching its goal of eliminating mother-to-child HIV transmission by 2030. But it's not all smooth sailing. There are some gaps in how this policy is being put into action. For example, not all pregnant women are visiting the clinic early enough. About half of the women in a recent study booked their first antenatal care visit before 20 weeks of pregnancy, which is what the policy recommends. The other half booked later, which can increase the risk of HIV transmission. Another issue is that not all HIV-positive pregnant women are starting antiretroviral therapy (ART) right away. While most women started ART on the day they were diagnosed, some didn't start early enough in their pregnancy. This can affect their viral load and potentially increase the risk of transmission. Viral load monitoring is also a concern. In the study, a quarter of women didn't have their viral load tested at their first antenatal care visit. Many others were only tested at delivery or six months after delivery. This is not ideal for keeping track of the virus and ensuring it's under control. Postpartum care is another area that needs improvement. Many HIV-positive women who were eligible for routine check-ups six to twelve weeks after giving birth missed these opportunities. This is a crucial time for monitoring both the mother's and baby's health. When it comes to the babies, most HIV-exposed infants received the necessary prophylaxis. However, not all babies were tested for HIV at the recommended times. Some were tested at birth, others at 10 weeks, and some at six months. A small number of babies seroconverted, meaning they tested positive for HIV after initially testing negative. These findings show that while South Africa is making progress, there's still work to be done to ensure that all mothers and babies receive the best possible care.