Mother-to-Child Transmission | HIV Prevention
Mother-to-child transmission is one of the main ways HIV can spread from one to the other.
This occurs especially in a positive pregnant mother who does not take antiretroviral medication (ARVs). Why is this so? What is all about these ARVs?
Well, for a positive mother who takes her ARV drugs appropriately definitely will reduce the risk of infecting the child.
As a matter of fact, proper ARV intake lowers viral load to a undetectable levels (commonly <LDL).
Moreover, during antenatal care, there are prevention drugs that she will receive for reducing the risk of infecting her child during and after delivery.
These drugs include Zidovudine and Nevirapine syrup.
Otherwise, a HIV positive mother can infect her unborn child during:
Ordinarily, the placenta does not allow movement of foreign bodies and by organisms between the mother and the foetus except for nutrients, oxygen and waste products.
Infection can also occur in the last trimester (i.e. from 28 weeks) because the mother is about to deliver.
So, the placenta gives chances to the HIV virus since there has been weakening.
b.) Mother-to-Child Transmission During Birth.
- The mother labours for long. Actually, prolonging labour can cause the membranes to rupture and therefore, the baby can easily get the HIV infection.
- If health providers use invasive procedures e.g. episiotomy
- If a traditional birth attendant (TBA) attends to her delivery. Some TBAs do not use gloves while others recycle
c.) Mother-to-Child Transmission after birth (postpartum) through :-
i.) Breastfeeding– Ideally, an HIV positive mother is not supposed to breastfeed but to introduce formula milk to the baby.
Where resources do not permit, health care providers normally advise a HIV positive mother to exclusively breastfeed.
The period is up to 6 months then stop abruptly and introduce weaning food to the baby. In addition, she can add formula milk in place of breast milk.
ii.) Mother-to-child transmission can also occur when a HIV positive mother shares sharp objects with the baby e.g. nail clippers
A breastfeeding HIV positive mother should take extra precautions on general hygiene and personal care. She should avoid breastfeeding if the nipples are cracked, if she has mastitis (inflammation of the breasts)
Therefore, when a positive pregnant mother visits an antenatal care clinic, the health providers must identify her first.
I usually advise PMTCT (Prevention of Mother-to-Child Transmission) to come with their sex partners.
This is just a comprehensive approach that the MoH has set. The Ministry of Health is always emphasizing on it to curb HIV transmission.
Definitely, an effective PMTCT Programme will consist of antenatal services that includes HIV Testing, a Comprehensive Care Clinic (CCC) for positive mothers to receive Antiretroviral Therapy (ART), Safe childbirth practices as well as appropriate infant feeding.
So, ART in summary reduces viral replication and can reduce mother-to-child transmission of HIV. How?
By either by lowering plasma viral load in pregnant women or through post-exposure prophylaxis in their newborns.