Makeletso’s Mission

Photo by Makopano Letsatsi/EGPAF 2023

Makeletso Khomonngoe, is a 27-year-old woman working as community mentor mother coordinator at mother2mother (m2m) in Mpharane Health Center in Mohale’s Hoek, Lesotho.

“We recommend pregnant mothers to visit antenatal clinic before 12 weeks of the pregnancy and also encourage them to be accompanied to the clinic by their partners,” says Makeletso.

She visits women in their homes and educates them at the health center and other community gathering places, educating them about the benefits of HIV testing and enrolling on antiretroviral (ARV) treatment if the result is HIV-positive. She encourages women living with HIV to monitor their viral loads to ensure viral suppression so that they can avoid passing HIV to their children. And she counsels women who test negative for HIV to take PrEP. (PrEP, or pre-exposure prophylaxis, reduces the risk of getting HIV.)

Supporting Other Mothers

In 2014, at the age of 18, Makeletso learned that she is living with HIV—when she was pregnant. She followed PMTCT protocols, and her baby was born HIV-free. She now uses her experience to encourage other women.

“We never get tired to educate and convince pregnant and breastfeeding women to take the right decision for their health and that of their babies,” says Makeletso, as she relates the example of a woman who tested positive for HIV but did not attend the clinic or start ARV treatment. The mother passed HIV to her child, who became very ill.

But Makeletso did not give up. After counseling, the mother changed her mind and accepted ARV treatment for herself and her baby, who is now healthy.

Makeletso also focuses on pregnant and breastfeeding women who are HIV-free, making sure that they are tested every three months to ensure that they are still negative—because some mothers may convert from negative to positive during that crucial period.

The Science of Support

HIV-exposed babies are now tested for HIV at birth. If a mother has a high viral load, their babies are classified as high-risk and given dual prophylaxis to the baby to prevent HIV transmission until the mother’s viral load is suppressed. The pregnant and breastfeeding mothers with high viral loads are closely monitored, and their viral load has to be done after every three months to ensure elimination of HIV from mother-to-child transmission.

Mothers and babies are closely monitored until the baby is 2 years. If the mother is not attending their appointments or clinic visits or has defaulted treatment, the clinic will inform the m2m mother mentor to track the defaulted mother and link them back to clinic to retain them on treatment to ensure they are virally suppressed so that they don’t transmit HIV to their children.

When pregnant and breastfeeding mothers work together with community health workers like Makeletso and professional health care workers in the facilities, no mother or child will be missed with HIV services—bringing the world closer to eliminating mother-to-child HIV transmission.

Makeletso joined the Now is the Time campaign to celebrate World AIDS Day 2023.