Pre-exposure prophylaxis (PrEP) is a highly effective HIV prevention tool, including for prevention of vertical transmission of HIV from mother to child. However, in the Democratic Republic of Congo (DRC), promotion of oral PrEP among pregnant women is low. 

In the DRC, oral PrEP has been available since 2020, but due to a number of barriers, including stigma, uptake has been a challenge. To scale up PrEP uptake among pregnant and breastfeeding women, ICAP at Columbia University engaged mentor mothers – women living with HIV who provide peer support for treatment adherence – and successfully initiated pregnant women on PrEP in Kisanga health zone for the first time.    

Mentor mothers not only supply women living with or at risk of HIV with essential information on treatment and vertical transmission, they also provide counseling, an important factor in combatting stigma surrounding HIV. With support from the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) through the Centers for Disease Control and Prevention (CDC), ICAP facilitated the development of a series of tools to ensure mentor mothers could help advance the PrEP program effectively. 

In January 2025, for example, ICAP developed a screening tool with qualifying questions to enable the identification of clients at higher risk of HIV infection and eligible for PrEP. ICAP also designed a flipchart and a counseling guide in French and Swahili to support mentor mothers in conveying simple and accurate messages on PrEP. For the quality implementation of education sessions and counseling support interventions related to PrEP, ICAP conducted a briefing session for mentor mothers followed by on-site coaching and mentorship in March 2025.  

Sainte-Bernadette, a health center located in the Kisanga health zone in Lubumbashi, organizes antenatal care – as well as health services for children under five – six days a week. On average, 145 pregnant women engage in antenatal care every month at Sainte-Bernadette. Via mentor mothers trained by ICAP, each pregnant woman receiving services at Sainte-Bernadette receives a message on PrEP twice. First, mentor mothers use the PrEP flipchart during group education sessions around health topics related to pregnancy, including vertical transmission of HIV and PrEP; and second, they use the PrEP counseling message guide during the individual HIV counseling session.  

The individual counseling session is an opportunity for the mentor mother to conduct an HIV risk assessment and assess the eligibility and readiness of the client to initiate PrEP. For the pregnant women eligible for PrEP, mentor mothers conduct PrEP literacy and adherence counseling sessions.  

“Seeing such enthusiasm among pregnant and breastfeeding women to take charge of their protection against HIV,” said Aimerance, an adherence and psychosocial support assistant at ICAP in DRC, “is a great step in the fight against HIV and AIDS in the DRC.”  

With the guidance and support of mentor mothers, 84 pregnant women at Sainte-Bernadette initiated PrEP during April-May 2025 for the first time – important progress toward reducing overall new HIV infections across the region.  

Philomene, a 25-year-old pregnant woman on PrEP receiving health services from Saint-Bernadette, said that initiating PrEP was a symbolic step.  

“PrEP is security, freedom, and a demonstration of love for yourself and your child,” she said.  

About ICAP

A major global health organization that has been improving public health in countries around the world for two decades, ICAP works to transform the health of populations through innovation, science, and global collaboration. Based at Columbia Mailman School of Public Health, ICAP has projects in more than 40 countries, working side-by-side with ministries of health and local governmental, non-governmental, academic, and community partners to confront some of the world’s greatest health challenges. Through evidence-informed programs, meaningful research, tailored technical assistance, effective training and education programs, and rigorous surveillance to measure and evaluate the impact of public health interventions, ICAP aims to realize a global vision of healthy people, empowered communities, and thriving societies. Online at icap.columbia.edu