Preventing HIV Infection

Preventing HIV in Pregnant Women

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What Can UNFPA Do?

The prevention of HIV in pregnant women and their partners is an integral component of UNFPA’s policy framework.

However, UNFPA will make significant impact by concentrating its support and resources on pregnant women.

UNFPA’s first and foremost responsibility is to work proactively to ensure that pregnant women’s health and survival are given the due attention deserved.

UNFPA must also ensure that equal attention is given to prevention of HIV infection in pregnant women as is being given by other partners to preventing HIV infection in infants.

In doing so, UNFPA must continue its work towards expanding access to quality maternal health services in the context of primary health care including antenatal care and emergency obstetric care.

Making comprehensive interventions widely available depends on the ability to influence political will and policy formulation; to strengthen existing human resources and infrastructures; and to mobilize adequate funds to implement the intervention package as described.

To contribute, UNFPA must:

Provide technical and policy support and strengthen national capacity to plan, design and integrate HIV/STI prevention services for pregnant women within existing reproductive health services.

Advocate for support for and building of effective partnerships among interested parties at global, regional and country levels to:
1) ensure that women’s needs are kept high on the HIV prevention agenda;
2) maximize available resources; and
3) ensure better coordination and integration of maternal health interventions.

Support the development and dissemination of IEC/BCC messages and materials on prevention of HIV infection in pregnant women which reflect a reproductive health and rights framework, cultural and social contexts, and which also promote the active involvement and support of male partners, families and communities.

Develop tools and protocols on HIV prevention among pregnant women aimed at strengthening skills of maternal health care providers to effectively deliver the comprehensive intervention package and to ultimately reduce the risk of transmission in pregnant women. This includes support to building the skills and capacity of health providers to: counsel and test for HIV status; screen and manage treatable STIs; counsel on infant feeding including breast feeding and replacement feeding; counsel and provide family planning services; inform and educate on HIV and safer and healthy sexual behaviours; provide and promote male and female condom use; adopt and ensure universal precautions are followed in all aspects of care; and provide quality antenatal, safe delivery and postnatal care.

Support the integration of programmes that educate outreach community volunteers and community health workers to provide to pregnant women, families and communities information on HIV/AIDS and STIs, VCT, safer sex practices including condom use, breast feeding and the importance of proper antenatal, delivery and postnatal care.

Facilitate procurement of reproductive health commodities and assist in the maintenance of functional and efficient logistics systems. The focus should be primarily on commodities for HIV prevention (STI and HIV test kits, male and female condoms, equipment and supplies for safe and clean delivery, and drugs for treatment of STIs). It must be noted that UNFPA will not use core resources to procure ARVs. Country offices should refer purchase of ARVs to other partners.

Specific UNFPA action at country level will vary; however, we must ensure the following:
In all countries Advocacy to ensure that prevention among pregnant women is kept high on the agenda of national counterparts and agencies.
Integration of HIV/STI prevention interventions into ongoing maternal health programmes including: 1) provision of information and education on safer sexual behaviour and breast feeding; 2) assessment of risk of HIV; 3) selective VCT for those at high risk4 ; 4) STI screening for all and STI management; 5) provision of condoms both male and female; 6) HIV/STI prevention IEC messages and materials.
In high prevalence countries All of the above plus:
1) VCT for all; 2) support for elective cesarean section for HIV positive women, if such a procedure can be safely provided by trained service providers, in a wellequipped facility, and with quality post-operative care; 3) appropriate referral for ARV drugs and further management.

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