Mother-To-Child HIV Transmission: Key Prevention Steps for a Healthier Future

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How HIV Can Pass from Parent to Infant

Mother-to-child HIV transmission happens when a parent with HIV passes the virus to their infant during pregnancy, childbirth, or breastfeeding. This type of HIV transmission accounts for the majority of infections in children under 15 years old.

Stages of Transmission

HIV can be transmitted to the baby in three main stages:

• During Pregnancy: The virus can cross the placenta, infecting the fetus. Preventing HIV in pregnancy through antiretroviral therapy (ART) significantly reduces this risk.
• Labor and Delivery: The baby can be exposed to the virus when it comes in contact with the parent's blood or body fluids.
• Breastfeeding: HIV can pass to the infant through breast milk. Safe feeding practices and HIV prevention in newborns are essential.

Risk Factors

Higher transmission rates are linked to factors such as a high maternal viral load, lack of HIV testing during pregnancy, and inadequate ART. Early diagnosis and consistent treatment are key for prevention.

The Impact of HIV Transmission from Mother to Baby

Mother-to-child HIV transmission can seriously impact a baby's health, leading to weakened immune systems and growth delays. Without timely intervention, infants may develop life-threatening infections. Early HIV testing during pregnancy is crucial to minimizing these risks.

Long-term Impact

Children who contract HIV face lifelong health challenges, including chronic infections, developmental delays, and complications from antiretroviral therapy. Preventing HIV in pregnancy through effective HIV prevention measures ensures a healthier future for the child.

The Role of Maternal Health  

Maternal health plays a significant role in preventing HIV in infants. Consistent prenatal care, including HIV testing during pregnancy, helps identify at-risk early. Adhering to antiretroviral treatment reduces the viral load, making prevention more effective.

Keeping mothers healthy directly decreases the chances of mother-to-child transmission and supports safer outcomes for newborns.

Key Prevention Steps for Mother-To-Child HIV Transmission

1) HIV Testing and Early Diagnosis

Routine testing during pregnancy is essential for early diagnosis, allowing timely intervention. When HIV is detected early, expectant mothers can begin antiretroviral treatment, significantly lowering the risk of passing the virus to their children.

2) Antiretroviral Therapy (ART) During Pregnancy

Antiretroviral therapy (ART) is key in protecting the baby during pregnancy. It helps reduce the virus's presence in the mother's body, minimizing the chance of transmission. Pregnant women should follow ART protocols before, during, and after childbirth to ensure ongoing safety for both mother and child.

3) Safe Delivery Practices

Selecting the appropriate delivery method can further reduce transmission risks. In some instances, a cesarean section may be recommended instead of a vaginal birth to limit the baby's exposure during labor. Coupled with ART, safe delivery practices significantly enhance protection for the newborn.

4) Postnatal Care and Infant Feeding Practices

For safe infant feeding, exclusive breastfeeding is recommended if the mother adheres to ART, as mixed feeding can increase HIV transmission risks. Alternatively, formula feeding may be considered in places with access to clean water and formula. ART is also available for newborns to prevent HIV  from mothers during the early months of life.

5) Family Planning and Contraceptive Use

It helps HIV-positive women to prevent unplanned pregnancies, lowering their chance of passing HIV to their children. Using safe birth control methods like condoms, IUDs, and hormonal options not only prevents pregnancy but also reduces the chance of HIV spreading during pregnancy. These methods support overall efforts to stop HIV transmission within families.

Global Efforts and Programs

International Initiatives

• WHO provides technical guidance, supports national programs, and advocates for policies to prevent HIV transmission. They have set global targets, including reducing new HIV infections among children by 90% by 2025 and by 95% by 2030.
• UNAIDS works to accelerate progress in ending HIV/AIDS as a public health threat. They provide technical and financial support to countries to implement prevention programs.
• The United Nations Children's Fund is vital in advancing the health and welfare of children. They advocate for policies that protect children from HIV infection, including those related to MTCT.

Challenges

• Stigma and Discrimination: Linked to HIV can prevent women from getting the healthcare services they need, including those for preventing HIV from mother to child.
• Limited Access to Healthcare: In many low-income countries, women often lack access to quality healthcare, making it difficult for them to receive essential health services.
• Insufficient Resources: Many countries struggle with limited resources, hindering their efforts to implement effective prevention programs.
• Cultural and Social Challenges: Social barriers may stop women from seeking or using prevention services for mother-to-child transmission.

MRCPCH: Advanced Pediatric Training for HIV Management

The MRCPCH Program provides advanced training for pediatricians, equipping them to manage complex health conditions in children, including those impacted by HIV. By understanding the challenges of pediatric HIV, MRCPCH-certified doctors can contribute to efforts to reduce child HIV transmission and improve long-term outcomes for affected children.