Since the first infections were reported in the early 1980s, HIV has grown into a pandemic with far reaching consequences for both individual health outcomes and national economies. In many countries most affected by HIV, prevalence among women is markedly higher than among men. Gender inequalities, abuse and physiological susceptibility to HIV make women more vulnerable to contracting the virus, and additional social, legal and economic disadvantages further increase risk.
As of 2009, the United Nations Joint Program on HIV/AIDS (UNAIDS) estimated that nearly 16 million women and 2.5 million children (0–14 years of age) were living with HIV. An additional 3,000 women and 1,000 children are newly infected with HIV every day. According to the World Health Organization (WHO), HIV is the leading cause of death among women of reproductive age worldwide, and approximately 5.8% of maternal deaths in 2008, globally, were due to HIV/AIDS. In sub-Saharan Africa, 9% of all maternal deaths were due to HIV/AIDS.
Progress toward Millennium Development Goals 4 and 5 has been eroded in countries with high HIV prevalence, particularly those most affected in sub-Saharan Africa. Despite these challenges, there has been a great deal of overall progress in prevention and treatment. In fact, according to data in UNAIDS 2010 Global Report on the Global AIDS Epidemic, HIV incidence has fallen by more than 25% between 2001 and 2009 in 33 countries, and virtual elimination of mother-to-child transmission of HIV is possible.
MCHIP HIV Programs MCHIP is working to build the capacity of both health workers and health systems to ensure the provision of high-quality care and respond to emerging priorities in HIV prevention, care and treatment. Specific intervention areas include: prevention of mother-to-child transmission of HIV (PMTCT); cervical cancer prevention for women living with HIV; preservice education for nurses and nurse-midwives; and voluntary medical male circumcision (VMMC) for HIV prevention.
MCHIP has championed global VMMC guidance encompassing not only the initial startup of VMMC programs but also their expansion. MCHIP has worked in collaboration with PEPFAR and other agencies to design and assess programs, identify bottlenecks to service delivery, redesign programs for efficiency and develop scale-up models to ensure that VMMC services are in the identified priority countries.
The MCHIP HIV team strives to:
Ensure that HIV-positive pregnant women who are treatment-eligible can initiate antiretroviral therapy (ART) in antenatal care.
Help countries move from single-dose nevirapine to more efficacious PMTCT regimens.
Integrate intensified case finding for tuberculosis (TB) into focused antenatal care in countries with high incidence of the disease.
Introduce early infant male circumcision (EIMC) in the East and Southern Africa region.
Reduce HIV incidence among men, women and children through rapid expansion of adult VMMC and related HIV prevention services.
Expand the single visit approach to cervical cancer prevention in HIV care and treatment settings.
Ensure that nurses and midwives in training graduate with the skills they need to care for women with HIV and TB.
Emphasize the critical role of family planning in PMTCT.
Ultimately, MCHIP aims to reduce HIV incidence among women, children and men, and to ensure that people with living with HIV and TB are promptly diagnosed and linked to high-quality care and treatment services.