Open AccessThe case for Option B and Optional B+: Ensuring that South Africa’s commitment to eliminating mother-to-child transmission of HIV becomes a reality
Author(s) -
Donela Besada,
Gilles Van Cutsem,
Eric Goemaere,
Nathan Ford,
Helen Bygrave,
Sharonann Lynch
Publication year - 2012
Publication title -
southern african journal of hiv medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.859
H-Index - 18
eISSN - 2078-6751
pISSN - 1608-9693
DOI - 10.4102/sajhivmed.v13i4.112
Subject(s) - medicine , breastfeeding , intervention (counseling) , population , government (linguistics) , efavirenz , human immunodeficiency virus (hiv) , transmission (telecommunications) , antiretroviral therapy , economic growth , family medicine , environmental health , nursing , viral load , pediatrics , economics , linguistics , philosophy , electrical engineering , engineering
In a previous issue of the Southern African Journal of HIV Medicine, Pillay and Black summarised the trade-offs of the safety of efavirenz use in pregnancy (Pillay P, Black V. Safety, strength and simplicity of efavirenz in pregnancy. Southern African Journal of HIV Medicine 2012;13(1):28-33.). Highlighting the benefits of the World Health Organization’s proposed options for the prevention of mother-to-child transmission (PMTCT) of HIV, the authors argued that the South African government should adopt Option B as national PMTCT policy and pilot projects implementing Option B+ as a means of assessing the individual- and population-level effect of the intervention. We echo this call and further propose that the option to remain on lifelong antiretroviral therapy, effectively adopting PMTCT Option B+, be offered to pregnant women following the cessation of breastfeeding, for their own health, following the provision of counselling on associated benefits and risks. Here we highlight the benefits of Options B and B+