Bujumbura – “It’s unacceptable that in 2024, children are still born with HIV,” says Novela Irakoze, a woman living who with HIV and advocate for prevention of mother-to-child transmission of HIV. “I was born with HIV and my goal is to protect children from experiencing what I did.”

Novela is part of a group called Mentor Mothers, which supports pregnant women living with HIV in receiving treatment to protect their babies from HIV.

By 2020, Burundi had made significant strides in combating HIV, nearing UNAIDS' 90‒90‒90 targets: 89% of people living with HIV knew their status, 98% were on HIV treatment and 90% had achieved viral suppression.

Despite improvements, preventing mother-to-child transmission of HIV remains a significant challenge. While 95.4% of all people living with HIV in Burundi receive antiretroviral (ARV) treatment, only 69% of pregnant women living with HIV do. The mother-to-child transmission of HIV rate is still above 12%, despite the national goal of reducing it to below 2%.

“To prevent transmission, it’s vital to keep both mother and child in care throughout the HIV exposure period,” says Dr Denise Nkezimana, WHO Burundi’s HIV, tuberculosis, and hepatitis programme manager. Yet, stigma and resource constraints often cause women to drop out of care.

In response to these challenges, the Burundian Government, in partnership with WHO, launched the Mentor Mothers pilot programme in 2019, which is a peer education initiative. So far, 135 women have been trained in three provinces, with plans to expand the initiative nationwide.

“Mentor mothers are mothers living with HIV who educate and support their peers through testing, treatment, and primary prevention,” explains Dr Aimé Ndayizeye, Director of the National AIDS Control Programme.

Mwanaidi Ndayishimiye, 30, discovered she was HIV positive during her first antenatal consultation. The news, while she was pregnant with her first child was devastating, and, due to stress, she lost her pregnancy after a fall. “It felt like my world was falling apart,” she recalls. With the help of the mentor mothers, Mwanaidi successfully carried her second pregnancy to term, giving birth to a healthy, HIV-negative child.

"The mentor mothers supported me during my second pregnancy. They educate us and encourage us to talk. It was of great help”, says Mwanaidi, now the mother of a 13-month-old HIV-negative child who is thriving.

With the involvement of mentor mothers, by 2023, all HIV-positive pregnant women will receive ARV treatment. The mentor mothers ensure that these women visit health centres regularly to monitor their HIV status and continue their treatment.

"We check the viral load at three months of pregnancy and again at six months to ensure that a woman gives birth with an undetectable viral load," explains Triphonie Yamuremye, Head of PMTCT Care at Buyenzi Community Medical Centre in Bujumbura.

To expand the success of the programme nationwide, WHO is supporting the development of a guide for mentor mothers and assisting Burundi in targeting certification for the triple elimination of mother-to-child transmission of HIV, syphilis, and hepatitis B.

"During a community visit, we met a 24-year-old woman who was pregnant and in critical condition. We feared that her baby might already be infected," recounts mentor mother Novela. "Thanks to our intervention, she and her child, who was born HIV-negative, are thriving today. These are the victories we fight for and we won't stop until Burundi is AIDS-free."