Preventing Mother-to-Child Transmission (MTCT) of HIV/AIDS

Preventing Mother-to-Child Transmission (MTCT) of HIV/AIDS


Hi, my name is Dr. Becky Kun. I’m a physician
who specializes in HIV/AIDS. Welcome to “Preventing Mother-to-Child Transmission of
HIV.” Are you pregnant or thinking about having
a baby? Then this video is for you. If you are HIV positive, it is entirely possible
to have an HIV negative baby. However, your child may become infected with HIV during
pregnancy, childbirth or while breastfeeding. If you take NO steps to protect
your child from HIV and breastfeed the baby, there is between one chance in five
and almost one chance in two that your child will become HIV positive. If you take NO steps
to protect your child and do not breastfeed, there is between one chance in
six and one chance in three that your child will
become HIV positive. But if you follow your doctor’s instructions,
including the use of AIDS medications, the World Health Organization estimates that you
can reduce the risk that your child will become HIV positive to less than one chance
in twenty. The United States Centers for Disease Control and Prevention estimates that
the risk can be reduced to one chance in fifty or less. If you are pregnant or thinking
about having a baby, the information in this video could save your child’s life, so please
watch the whole video and listen carefully. See a Doctor
If you know you are pregnant or are thinking about having a baby, see a doctor. They can
give you health advice that will give you the best chance of a safe pregnancy and a
healthy baby whether or not you have HIV. Get Tested for HIV and Other Sexually Transmitted
Infections No matter how far along you are in your pregnancy,
get tested for HIV and other sexually transmitted infections right away. The United
States Centers for Disease Control and Prevention recommend that all pregnant women
be tested for HIV and other sexually transmitted infections including chlamydia,
Hepatitis B, and syphilis. The World Health Organization recommends that all pregnant
women be tested for HIV and syphilis and asked about symptoms of other sexually transmitted
infections. You may be HIV positive or have another sexually transmitted
infection and not know it. In most places, testing for HIV and other
sexually transmitted infections is free. If You’re HIV Positive or Have Another Sexually
Transmitted Infection, See a Doctor Right Away
If you are HIV positive or have a sexually transmitted infection, do not despair. With
modern AIDS medications, HIV positive people may remain healthy for years or
decades. Many other sexually transmitted infections can be cured with antibiotics.
The rest of this video will tell you about some of the steps your doctor may recommend
to protect your infant if you are pregnant and HIV positive. Remember, different people
have different needs, and different medications and treatment options are available
depending upon where you live. Watching a video is no substitute for seeing a doctor
and getting personal advice that’s right for you.
AIDS Medications HIV is the virus that causes AIDS. AIDS medications
known as Antiretroviral Medications (ARVs) can prevent HIV from reproducing
within your body. Your doctor will recommend that you take AIDS medications
to protect your baby. When your doctor prescribes AIDS medications, it’s extremely
important to take every dose of the medications on schedule. A separate video
called “Adherence for Life” explains why this is so important.
If You’re Already Taking AIDS Medications, Talk With Your
Doctor and Keep Taking What They Recommend If you are already taking AIDS medications,
your doctor will keep you on AIDS medications in order to protect both you and
the baby. Starting AIDS Medications Immediately
Your doctor may start you on AIDS medications immediately if you are not already on
them. Your doctor is especially likely to do this if you are showing symptoms of clinical
AIDS, your CD4 immune cell count is low, or the amount of HIV in your body is high.
Starting AIDS Medications Later During Pregnancy Even if your doctor doesn’t recommend that
you start AIDS medications immediately, where possible, they will put you on AIDS
medications later in your pregnancy to protect the baby. As of 2011, the World Health Organization
recommends that if you don’t need AIDS medications for your own health, you
should still begin taking them as early as 14
weeks into the pregnancy to reduce the risk of HIV transmission to the baby.
Scheduled Caesarian Section In some cases, such as a woman with a high
amount of HIV in her body, the risk of mother-to-child transmission of HIV may be
lower if the child is delivered via a scheduled Caesarian section rather than by
a natural vaginal delivery. However, Caesarian sections have their own risks for
the mother and the child. If a woman is on AIDS medications and the amount of virus in
her body is low, vaginal delivery may have no more risk of HIV transmission than Caesarian
section and is commonly chosen. Intravenous (IV) AIDS Medications During Labor
and Delivery Where possible, every HIV positive woman should
receive intravenous AIDS medications during delivery, once her water
has broken. Where this is not possible, your doctor may give you oral AIDS medications
to take when you go into labor. AIDS Medications for the Child After Delivery
You can further reduce the risk that your baby will contract HIV by giving your baby
oral AIDS medications after delivery. It’s critical
that you give the baby every dose of medication on schedule.
If you are breastfeeding the child, you must give the child AIDS medications until at
least one “week after all exposure to breast milk has ended.”
If you stop breastfeeding the child before the child is six weeks old, or if you are
feeding the child only infant formula, you must give the child AIDS medications until
at least four to six weeks after birth. Feeding the Child Formula Instead of Breastfeeding
HIV can be transmitted to the baby through breast milk. Feeding your baby only infant
formula can further reduce the risk your child will contract HIV. For infant formula to be
considered, it must be safe for you and your child. For example, you must have reliable
access to clean water and infant formula. Your doctor may recommend that you feed the
child infant formula instead of breastfeeding. If you follow all your doctor’s instructions
and feed the child only infant formula, you can reduce the risk that your child will
contract HIV to as little as one chance in fifty.
AIDS Medications During Breastfeeding Feeding your child with infant formula may
not be possible. For example, you may not have reliable access to clean water or may
not be able to afford infant formula. When infant formula can’t be used, your doctor
will recommend that you breastfeed your baby. The doctor will also recommend that you take
AIDS medications for at least as long as you are breastfeeding. This will reduce the
risk that HIV will be transmitted to your baby
through your breast milk. If you follow all your doctor’s instructions and breastfeed
the child, you can reduce the risk that your child
will contract HIV to less than one chance in
twenty. Don’t Mix Breastfeeding and Feeding with Infant
Formula Either breastfeed your child or feed your
child infant formula, but don’t do both. Feeding the child both breast milk and infant formula
increases the risk that the child will contract HIV, become ill, or die.
AIDS Medications for the Mother After Delivery or After
Breastfeeding Ends Your doctor may tell you to stay on AIDS medications
permanently to protect your own health. In a number of developed countries,
many women who start taking AIDS medications stay on them. However, depending
on treatment guidelines in your country, the doctor may have you continue taking AIDS
medications for only a short period after delivery (if you are feeding the infant with
formula) or after breastfeeding ends to reduce the risk that AIDS medications won’t work
against HIV in the future. Testing the Baby for HIV
All babies born to HIV positive mothers should be tested for HIV. Your doctor will tell
you when and how your baby should be tested for HIV. Babies can’t be tested for HIV
using ordinary adult HIV tests until at least one year after delivery, but they can be tested
using a special test that looks for HIV in their blood. If a baby tests HIV negative
one year after delivery, the baby is considered
HIV negative. If Your Child is HIV Positive
If your child turns out to be HIV positive, do not despair. With appropriate treatment,
HIV positive children may be able to live a healthy life. There are college students
today who were born as HIV positive infants. If
your child is HIV positive, talk with your doctor about how to keep them healthy and
make sure to follow the doctor’s instructions exactly.
Important Things to Remember Let’s close by reviewing some of the most
important lessons from this video. If you think you are pregnant or want to become
pregnant, see a doctor and get tested for HIV.
If you are pregnant and HIV positive, there are many things you can do to reduce the
risk of mother-to-child transmission of HIV. Talk to your doctor about what to do and
follow the doctor’s instructions exactly. For AIDSvideos.org, this is Dr. Becky Kuhn.

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