Tuesday, October 09, 2012

Option B+ and treatments for pregnant women living with HIV in Africa



At the International AIDS Conference in Washington in August 2012, a presentation was given by UNICEF on an approach to reduce vertical transmission in resource poor settings. Positively UK has mixed reactions to this proposal, known as Option B+. 

The new approach is to test all pregnant women, without mention of it being voluntary and access to counselling, and for all those who test positive for HIV, put on a course of Truvada and Efavirenz. Through a pilot in Malawi, UNICEF have found that this approach reduces risk of transmission of HIV to unborn children, transmission to HIV negative partners and increases mothers’ life expectancy.
A programme achieving these outcomes should be highly commended. However Positively UK is concerned that;
this approach is too narrow and is contrary to the human rights of women, and men, living with HIV. Access to HIV treatments should be universal; in addressing only women who are pregnant Option B+ fails to provide equal access to women who are not pregnant, and men. 

Secondly people living with HIV should have access to second line treatment, should the first line fail due to the persons’ reaction to the medication, or their body developing a resistance to it. Option B+ provides no guarantee that second line treatments will be available. 

Thirdly, there is evidence of extensive gender based violence for women living with HIV in Africa, including within healthcare settings with coerced sterilization of positive women, as well as widespread intimate partner violence. Compulsory HIV testing within this context of widespread human rights abuses may put the lives of women living with HIV at risk. 

Fourthly, as a community organisation, Positively UK recognises the importance of involving people living with HIV in all decisions that affect them; from a personal level in taking medications, to involvement in national health policy. Option B+ provides neither. 

Instead it implements a top down approach, with no involvement of people living with HIV and the communities HIV affects; this involvement is vital to ensure human rights are upheld and people are in control of their own health. We would not accept such an approach in the UK, and we should not accept it in developing countries. 

Positively UK supports Option B+, when accompanied by universal access, second line treatment, the full respect of human rights, and the greater involvement of people living with HIV in its formation and implementation at national level. 

We urge the international community to address this issue, and promote the UN AIDS principle of the greater involvement of people living with HIV in this programme.


The statement is taken from Positively UK website here. You can find more information or details on this issue by visiting the website here.

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