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Feature HIV

Mentor mothers to prevent mother-to-child transmission of HIV

BMJ 2012; 344 doi: (Published 12 March 2012) Cite this as: BMJ 2012;344:e1590
  1. Karen McColl, freelance writer
  1. 1Savoie, France
  1. karenmccoll{at}

As Southern African policy makers gather in London this month to discuss strategies for reducing new HIV infections in children, Karen McColl reports on an initiative that uses affected mothers to provide support

Obstetrician Mitch Besser realised that there were some challenges in his work to prevent mothers with HIV infection from passing the virus to their babies that would be difficult to overcome. Having recently moved to South Africa from the US, he didn’t have the right language skills or a full understanding of the culture he was working in. Pregnant women and new mothers needed explanations that he was simply not able to give. Quickly working out that the people best suited to providing these explanations were mothers who were similarly affected, Dr Besser asked some of his former patients to help. These mothers sat in on consultations, helped to interpret, and explained testing and treatment to women coming to his clinic at Groote Schuur hospital in Cape Town.

What started as a few mothers providing education and support to their peers has now evolved, 10 years on, into an international programme operating on 589 sites in seven countries. mothers2mothers (m2m), the organisation established by Mitch Besser and colleagues to develop this model of peer education and psychosocial support, now employs 1457 mentor mothers.

In rich countries, new cases of HIV in children have been virtually eliminated. Effective care to prevent mother-to-child transmission—comprising HIV testing, antiretroviral treatment and prophylaxis for mothers and babies, and safe infant feeding—can reduce the risk of a mother passing the virus to her baby to less than 5%. Yet, every day in Africa 1000 babies are born with HIV, and only just over half (53%) of pregnant women in poor and middle income countries receive antiretroviral drugs to prevent HIV transmission.

Last year …

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