Pre-pregnancy and adolescence HIV prevention education including safer sexual practices Messages to use condoms consistently and correctly to prevent infection with HIV and other STIs and unintended pregnancy Pre-conception family planning counseling for living with HIV and their partners to prevent unintended pregnancy and promote dual protection (condom + another contraceptive method) Pre-conception counseling for living with HIV who desire a child and their partners, including information on ART treatment Integrate family planning counseling and contraceptives into HIV services Organize an awareness campaign on PMTCT topics for pregnant women and their partners
Conduct Life Skills training for adolescents to gain skills to improve communication with sexual partners on HIV safe sex practices, and the benefits of getting tested for HIV Pregnancy Encourage men to accompany women to ANC and involve men in PMTCT activities using a “men as partners” approach Encourage pregnant partners, and family members to get voluntary testing and counseling for HIV Educate pregnant women living with HIV on their increased risk of developing active TB, the risks that TB poses to themselves and their baby, and where to get tested and treated for TB
Distribute ITNs to pregnant women and promote intermittent prophylactic treatment (IPTp), as pregnant women are at greater risk if they get sick with malaria and because of the increased risk of HIV transmission to newborns if they get sick with malaria Encourage HIV positive pregnant women to be tested and treated for STIs as STIs with open sores and lesions increases a women’s likelihood of acquiring HIV by 2-3 times Help HIV positive pregnant women to identify strategies to adhere to treatment
Educate pregnant with HIV on safer infant feeding (as per country policies) Provide information to pregnant women and their partners about HIV transmission in general, about transmission of HIV infection to infants and young children, and about how risk is increased if a mother becomes infected with HIV at the end of pregnancy or during breastfeeding Refer HIV-positive pregnant women to trained infant feeding counselors who can speak with them in depth on infant feeding options in the context of HIV and provide adequate support and follow up
Birth and Delivery Encourage HIV-positive pregnant women to deliver their children in a facility with a trained birth attendant Link postpartum women to a support group and refer them to HIV care and support services Educate HIV-positive women in the delivery room about danger signs to look for at home, treatment adherence, early infant diagnosis, nutrition and infant feeding, options for family planning, partner and family testing, and disclosure support Postnatal Period Help mothers of newborns identify strategies to adhere to treatment during postnatal visits Educate HIV-positive mothers with newborns on safer infant feeding according to country policy Educate postpartum women and their partners on family planning
Engage community members to support exclusive breastfeeding and address stigma related to infant feeding (for any women who choose not to breastfeed) Educate HIV-positive mothers on need for early identification of newborns and to bring their infant for HIV testing at 4-6 weeks, as per national protocols Educate HIV-positive mothers to give newborn ARV prophylaxis as per national protocols Support early and regular postnatal visits and follow up of mothers and infants to provide special care, including cotrimoxazole, early diagnosis, access to ARV, and support of infant feeding practices Support breastfeeding counseling of mothers to decrease risks of breast inflammation and other conditions that may increase the chance of HIV transmission Educate and mobilize community leaders and influential family members on PMTCT All stages (at family, community, and facility levels)
Sensitize health service providers on how PLHIV experience stigma and discrimination in health facilities and then train them to reduce stigma and discrimination and promote respectful care Sensitize men and communities about the need to address intimate partner violence against women Sensitize community leaders and members to reduce HIV-related stigma and discrimination through traditional and modern entertainment methods, such as theater and radio and use of influential spokespeople Create support groups for postpartum HIV-positive to support disclosure, treatment adherence, and reduce self-stigma