During my residency at STIAS I will be analyzing data and completing two scientific papers on HIV prevention, in particular the prevention of mother to child transmission (PMTCT) in sub-Saharan Africa, specifically in Kenya and Tanzania where I have ongoing projects and data is being collected. The very recent decision by these countries to roll out the WHO proposal of Option B+, i.e. initiating all HIV infected pregnant women on life long anti-retroviral treatment regardless if their immune status (immediate need) and not only under the pregnancy and breast-feeding periods in order to protect the infant from HIV infection, has both obvious benefits but also several challenges.
The benefits include for example reduced transmission risk to sexual partners and reduced morbidity and mortality of the women. On the other hand, there are also large challenges related to health systems weaknesses and staff shortages limiting the capacity to monitor and support the women. Social stigma and difficulties of partner disclosure of HIV status, hinders many women to adhere to the HIV treatment putting them at risk of drug resistance, infecting their infants and their partners and of premature death.