2015 Rwanda - Riedel


Prevalence of HIV infection among children born to HIV-infected mothers after the implementation of Option B+ in Rwanda and barriers to PMTCT care

Summer 2015

Led by David Riedel, MD, MPH, School of Medicine

Students (school affiliation): Adele Hartman (nursing) and Brooke Hyman (medicine)

Project goals

The goals of the project were to determine the prevalence of HIV infection among children born to HIV-positive mothers after the Option B+ program was implemented in Rwanda, and to identify barriers of prevention of mother-to-child transmission (PMTCT) care to pregnant women who were HIV-positive.

Project description

Students from the Schools of Medicine and Nursing traveled to the Rwanda's capital in Kigali to participate in ongoing research led by Dr. David Riedel. The students prepared a survey to interview health care providers and pregnant women in order to identify barriers to efficient delivery of PMTCT care. This information was written up and shared with the Rwandan heads of the PMTCT program. Students also analyzed PMTCT data and determined a HIV prevalence of 1.8% among 18-month infants born to HIV-infected mothers after the Option B+ program was rolled out in Rwanda in 2011. Further analysis of this data is ongoing.

Dr. Riedel presented and was on a panel at a regional HIV Guideline Review workshop and invited the students to attend. During the workshop, Rwanda debated moving forward with their guidelines to treat all people with HIV infection, regardless of their CD4 count; Rwanda would be the first country in Africa to take this step.

Students gained a significant appreciation of working in a developing country context, particularly as it relates to the pace of the project and the day-to-day operations of the project. They specifically gained firsthand knowledge of the barriers that women and providers face in one HIV program (PMTCT) in Rwanda. They had adequate time in Rwanda and exposure to various clinic sites and people to gain an appreciation of Rwanda’s history, people and culture.