We recently sat down with Florence Kasende, who serves as a Senior Study Coordinator for the PURE study aimed at improving Prevention of Mother-to-Child Transmission Treatment Uptake and Retention in Malawi. Florence, who is pregnant and expecting her first child this month, shared her perspective about this important research aimed at building an AIDS-free generation.
Q: Tell us a bit about what you do at Dignitas and what drew you to work with the organization.
A: Dignitas’s vision – to transform patient health and health care systems for the most vulnerable – inspires me. I want to contribute to this vision and work in the hard-to-reach communities where Dignitas is working. I have been with the organization for about two and a half years now and I serve as the Senior Study Coordinator for the PURE research study. I am responsible for the implementation of this study in Malawi’s southeast region.
Q: Tell us more about the PURE research study. What is the objective of this study?
A: The objective of the PURE study is to explore whether enhanced support for women and their families will result in more mothers enrolling and staying on HIV treatment as part of Malawi’s prevention of mother-to-child HIV transmission program. The study is specifically investigating whether using Expert Patient mothers (HIV+ patients that provide peer counselling to newly diagnosed patients) at health facilities or in the community will improve rates of uptake and retention in HIV care. By figuring out which support models work best, we hope to improve the likelihood of mothers and families starting and remaining in HIV care.
Q: Mother-to-child transmission is the most common source of HIV infection in children. Why is this study an important one?
A: This study is so important because if we are able to ensure that HIV+ expectant mothers start and stay on HIV treatment, we can greatly reduce the likelihood that these mothers will transmit the virus to their babies. In addition, if women are retained in HIV care, they are more likely to remain healthy so they can care for and raise their children. They will also have access to regular support and education throughout their pregnancy and motherhood – which means we can make sure that both mothers and babies get the health care they need, when they need it.
Q: Tell us about Option B+ and why Malawi has adopted this approach to eliminate mother-to-child transmission.
A: Option B+ is an ambitious program aimed at eliminating mother-to-child transmission of HIV. The program offers all HIV+ pregnant and breastfeeding women immediate and lifelong HIV treatment regardless of how advanced their disease is. This strategy has a double-pronged benefit – it keeps mothers healthy and it prevents transmission of the virus to their babies. Malawi was the first to roll out this program in 2011 but now more than 20 countries around the world have adopted this WHO-endorsed strategy.
Q: How is the study being conducted? What will you be measuring?
A: The PURE study will evaluate whether adding either clinic-based or community-based peer support to the Option B+ program will improve the likelihood of mothers and families starting and remaining in care. This will be done using a three-arm cluster randomized control trial.
Q: Who is Dignitas partnering with on this study?
A: Dignitas is partnering with the Malawi Ministry of Health, Management Sciences for Health, the University of North Carolina Project-Malawi, the University of Malawi-College of Medicine’s Malaria Alert Centre, the University of Malawi-Chancellor College, mothers2mothers and the London School of Hygiene and Tropical Medicine.
Q: How will the outcomes of this study change the way health care is delivered in Malawi?
A: The results of the PURE study will help to inform Malawi’s health policy on the Option B+ prevention of mother-to-child transmission program as well as the national guidelines for delivering integrated HIV treatment and care.
Q: As a mother-to-be, why is this study important to you and other mothers in Malawi?
A: This study is important because every mother hopes to give birth to a healthy baby. This study will ultimately help women living with HIV better access the treatment and care that will prevent their infants from contracting HIV.
Q: What is your hope for your child and future generations of Malawians?
A: I hope that my baby will enjoy good health and be able to access good health care when she needs it. I also hope that with the tools we are implementing to prevent mother-to-child transmission, we will soon see an AIDS-free generation.
Q: What would you like to say to the donors that support our work?
A: I am very thankful for the donor support we receive at Dignitas. Without this, we would not be able to offer the programs we are implementing now. Our supporters should know they have greatly contributed to improving the health of the people of Malawi. I hope our donors continue supporting our lifesaving medical and research programs in whatever they can.