Neftaly Perinatal HIV Transmission Prevention
Overview
Perinatal HIV transmission — also known as mother-to-child transmission (MTCT) — occurs when HIV is passed from a mother to her baby during pregnancy, childbirth, or breastfeeding. With proper prevention measures, the risk can be reduced to less than 2%. Early diagnosis and comprehensive care are key to safeguarding maternal and child health.
Key Strategies for Prevention
1. Routine HIV Testing and Early Diagnosis
- Offer opt-out HIV screening to all pregnant women during their first antenatal visit.
- Repeat testing in the third trimester for women at high risk.
- Provide partner testing and counseling to identify and treat both parents.
2. Antiretroviral Therapy (ART)
- Initiate lifelong ART as soon as HIV is diagnosed, regardless of CD4 count or viral load.
- Aim for viral suppression before delivery to significantly lower transmission risk.
- Monitor adherence closely through counseling and follow-up.
3. Safe Delivery Practices
- For women with undetectable viral load: Vaginal delivery is generally safe.
- For women with high viral load: Consider scheduled caesarean section at 38 weeks to minimize exposure during birth.
- Avoid procedures that increase the baby’s exposure to maternal blood (e.g., artificial rupture of membranes, fetal scalp electrodes).
4. Infant Prophylaxis
- Administer antiretroviral prophylaxis (e.g., nevirapine or zidovudine) to the newborn as soon as possible after birth.
- Duration depends on maternal viral load and treatment status.
5. Safe Infant Feeding
- In settings with safe water and affordable formula: Exclusive formula feeding is recommended.
- Where formula feeding is not safe or feasible: Exclusive breastfeeding for the first 6 months with maternal ART is advised, followed by rapid weaning when safe alternatives are available.
6. Ongoing Maternal and Infant Care
- Continue ART for the mother postnatally.
- Regularly monitor the baby for HIV with PCR testing at recommended intervals (birth, 6 weeks, and as advised).
- Provide immunizations, nutrition support, and psychosocial care.
Community and Health System Support
- Strengthen PMTCT (Prevention of Mother-to-Child Transmission) programs.
- Provide education campaigns to reduce stigma and encourage early antenatal care.
- Ensure continuous drug supply and accessible healthcare facilities.
Key Takeaway
Perinatal HIV transmission is largely preventable with early testing, consistent ART, safe delivery practices, and appropriate infant feeding. Comprehensive maternal and infant care can help achieve an HIV-free generation.
