Preventing mother-to-child transmission of HIV

Introduction:

Mother-to-child transmission of HIV is the spread of HIV (the human immunodeficiency virus) from an infected mother to her baby during pregnancy, labour and through breastfeeding. It is also referred to as vertical transmission of HIV.

In the absence of preventive measures, between 15% and 40% of babies born to HIV-infected mothers will also become infected with the virus. However, this can be reduced to less than 5% with the use of appropriate interventions.

Globally, Nigeria accounts for the highest number of children infected with HIV. This is sad because vertical transmission of HIV is largely preventable. The technology, materials and expertise to prevent vertical transmission of HIV is within our reach. Why then do so many of our babies become infected with HIV?

Risk factors

Several factors increase the risk of vertical transmission of HIV.  These risk factors may be classified as maternal, foetal , virological and obstetric factors. For example, a woman with advanced HIV infection has a higher chance of transmitting the virus to her baby. Prolonged labour or delivery increases the risk of vertical transmission of HIV.

Similarly, babies born prematurely are more likely to become infected with the virus.  Mixed feeding greatly increases the risk of vertical transmission of HIV. Mixed feeding occurs when babies are given breast milk in addition to other food or drink before the age of six months.  Moreover, a HIV-infected mother who experiences cracked nipples while breastfeeding  may transmit the virus to her baby

Preventive Strategies

How can we prevent mother-to-child transmission of HIV? The World Health Organisation (WHO) has a four-prong strategy for preventing vertical transmission of HIV. The four prong-strategy is as follows:

1. Preventing HIV infection in women of the reproductive age-group and their partners. If women in the reproductive age-group are not infected with HIV, the risk of vertical transmitting of HIV will be eliminated. This strategy is implemented through HIV counselling and testing of pregnant women attending antenatal clinics.
2. Preventing unintended pregnancies among HIV infected women. Preventing unintended pregnancy will reduce the risk of vertical transmission of HIV. This strategy is accomplished with the use of modern contraceptive methods.
3. Preventing transmission of HIV from a pregnant woman to her baby during pregnancy, labour or through breastfeeding. This is achieved through a combination of several interventions. The use of antiretroviral drugs by mother and her baby reduces the chances of the baby becoming infected with HIV. Safer delivery practices adopted by health workers helps to reduce the risk of vertical transmission of HIV even further.
4. Care and support for HIV positive women, their children and families. Using this strategy, children and partners of HIV-infected women are counselled and tested for HIV. Those found to be infected with HIV are linked to proper care and treatment.

The call to action:

Vertical transmission of HIV infection is preventable. We have the knowledge and skills to achieve this goal.  Let us work together to eliminate vertical transmission of HIV in Nigeria. It is possible. It is doable. The future is now…#EMBA27