Prevention of Mother to Child Transmission (PMTCT)

A woman who is HIV-infected may transmit HIV to her baby during:

• Pregnancy
• Childbirth
• Breastfeeding

What is Mother to Child Transmission (MTCT)?

Choose a time and place that's relaxed and comfortable before you get intimate (ideally that means before you take your clothes off!). Be sure to know plenty of important facts so that you can answer any questions your partner may have. You might want to start the conversation on a positive note - for example, by telling your partner that you really care for him or her and that's why you want to discuss something important.

Is MTCT a major problem?

In 2007, approximately 400,000 children under 15 became infected with HIV, mainly through mother-to-child-transmission. About 90 per cent of these MTCT infections occurred in Africa where AIDS is beginning to reverse decades of steady progress in child survival.

In high-income countries MTCT has been virtually eliminated thanks to effective voluntary HIV testing and counseling, increased access to antiretroviral therapy (AIDS drugs), safer delivery practices, and the increased availability and safe use of breast-milk substitutes. If these interventions were used worldwide, they could save the lives of thousands of children each year.

Can MTCT be prevented?

Yes, it can. The risk of transmission of HIV from mothers to their babies can be almost eliminated. The programme to prevent mother to child transmission is referred to as Prevention of Mother to Child Transmission (PMTCT). PMTCT strategies include:

• Preventing HIV infection among prospective parents mainly by ensuring consistent condom usage and regular HIV testing
  
• Avoiding unwanted pregnancies among HIV positive women by ensuring early diagnosis of HIV status (regular testing) and access to reproductive health services including contraception.
  
• Preventing the transmission of HIV from HIV-positive mothers to their infants during pregnancy, labour, delivery and breastfeeding.
  

What does PMTCT involve?

PMTCT involves initiating anti-retroviral treatment for the mother during her pregnancy and during labor., as well as the administration of anti-retroviral drugs for the baby during delivery. And the mother must either exclusively breastfeed or use only milk substitutes. Mixed feeding greatly increases the risk of HIV infection after birth. And the mother may need to continue on anti-retroviral treatment for the rest of her life.

The effectiveness of PMTCT depends largely on early access by pregnant women to ante natal clinic services to establish her HIV status and if positive to begin the mother on anti-retroviral drugs as early as the first three months of pregnancy. The earlier the mother begins treatment the better the odds the baby will be born HIV negative.

Many factors complicate access to PMTCT services. AIDS stigma is a major barrier because pregnant women are fearful of negative repercussions of an HIV positive diagnosis from their male partners, and others in their family and community. Older women who have traditional views about child birth and breastfeeding are also an obstacle. And most important of all is the fact that PMTCT services are not universally available.

Why are so many pregnant women not receiving the help they need?

Most often it is because PMTCT services are unavailable or inefficient, or because women are unable to access them. Stigma and fear may also play a role by making a woman unwilling to take an HIV test, or unwilling to take PMTCT drugs.

Can’t children with HIV be treated with antiretroviral drugs to stop them developing AIDS?

Treatment for children is possible, and some HIV positive children are being treated with great success. But paediatric treatment is costly and often difficult to administer in resource-poor settings. Preventing a child from becoming HIV infected in the first place is always a better solution.

What can I do while I am pregnant to prevent my baby from becoming infected with HIV?

• Get antenatal care.
  
• Get tested for HIV and bring your partner for HIV testing.
  
• If you have HIV, enrol for the PMTCT programme as described above.
  
• If your test is negative, learn how to stay negative.
  

You can reduce the risk of transmitting HIV to your baby.

When you are pregnant:

Get tested to learn your HIV status. If you know you have HIV, you can lower the risk of passing the virus to your baby. By ensuring you go to an ante-natal clinic early (in the first three months) enrol in the PMTCT program and, attend all your clinic visits. It is also essential that you adhere to the PMTCT programme once you start it.

Ask your medical provider about the medicines that can reduce the risk of passing HIV to your baby.

Ask your medical provider about feeding options to reduce the risk to your baby:

• Replacement feeding
  
• Exclusive breastfeeding