The Jakarta Post
In a bid to stem the rising mother-to-child transmission of HIV/AIDS in Semarang municipality, Central Java, the local administration will enlist the help of midwives.
According to chairman of the municipal branch of the Indonesian Family Planning Association (PKBI), Dwi Yoga Yulianto, midwives play a vital role in preventing mother-to-child transmission (PMTCT) of HIV.
'Midwives can reach more women of reproductive age in all levels of society, especially the pregnant ones,' Dwi said on the sidelines of a training session held for midwives on pregnant mother reference and HIV/AIDS prevention in women and children in Semarang on Friday.
Some 80 percent of expectant mothers, Dwi said, go to midwives for a check-up during their pregnancy. Midwives, he added, were also considered to have a better rapport with patients compared to doctors.
More importantly, they deal with more patients from impoverished families that have limited access to health and good understanding of HIV/AIDS.
Once involved in HIV/AIDS prevention measures, the midwives will be tasked with monitoring pregnant women for HIV infection.
'If they observe signs of infection, they will send the woman for a test,' he said, referring to the PMTCT program that comprises four activities or prongs.
The four prongs include offering all pregnant women HIV tests; providing HIV-positive pregnant women with anti-retroviral (ARV) drugs; selecting the right family-planning program for HIV-positive women and deciding the safest birth methods for HIV-positive pregnant women followed by providing the newborns with the best nutrition.
Data at the Semarang municipal health agency show that HIV/AIDS transmission from mother to child accounts for 2.6 percent of the total HIV/AIDS cases reported nationwide. In Semarang itself, during the period of 1995 to 2012, there were 2,351 reported cases of HIV infection and 364 cases of AIDS of which 57 proved fatal. HIV-positive expectant mothers numbered 13 in 2011 and 28 the following year.
The move by the municipal administration to involve midwives in HIV/AIDS prevention measures received a warm welcome from Bambang Darmawan, a supervisor with NGO Griya Asa, which has specialized in HIV/AIDS monitoring in the Sunan Kuning red light district in Semarang.
Bambang said that prostitutes often got pregnant despite the fact that they were high-risk in terms of HIV transmission. During 2012 alone, he said, 35 commercial sex workers operating in Sunan Kuning were infected with HIV.
He also said that the majority of prostitutes went to midwives when they got pregnant.
The government, according to Bambang, should conduct PMTCT tests consistently in all high-risk areas such as Yogyakarta, Surabaya (East Java), Batam (Riau Islands), Denpasar (Bali) and Semarang.
Unless well handled, the possibility of HIV transmission from HIV-positive expectant mothers is between 24 percent and 45 percent. With early detection, Bambang, said the possibility could be reduced to just 5 percent.
Separately head of the training division of the Semarang branch of the Indonesian Midwives Association (IBI), Suprapti, assured that all the association's 500 members in the city had been conducting HIV early-detection programs.