Unit 2 mtct and prevention strategies

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Unit 2 mtct and prevention strategies

  1. 1. Factors that increase transmission and strategies to reduce transmission
  2. 2. Session Objective and content <ul><li>Objective: At the end of the session the participant should be able discuss MTCT, and transmission factors that may increase transmission and measures that reduce transmission </li></ul><ul><li>Content </li></ul><ul><ul><ul><li>Timing of transmission </li></ul></ul></ul><ul><ul><ul><li>Factors influencing transmission (risk factors) </li></ul></ul></ul><ul><ul><ul><li>Interventions to reduce transmission – 4 elements of perinatal HIV prevention </li></ul></ul></ul>
  3. 3. Mother-to-Child HIV Transmission <ul><li>MTCT is responsible for over 90% of childhood HIV infections. </li></ul><ul><li>MTCT can take place: </li></ul><ul><ul><li>During pregnancy </li></ul></ul><ul><ul><li>During labour and delivery </li></ul></ul><ul><ul><li>Postnatal due to breastfeeding </li></ul></ul><ul><li>Overall, the transmission rate is 40% without interventions. </li></ul>
  4. 4. Timing of transmission 30-40% 25-35% 15-30% Total 5-10% 5-10% 5-10% 1-5% Postpartum Early (1 st 2 months Late (After 2 months) 10-20% 10-20% 10-20% Intra partum 5-10% 5-10% 5-10% Intrauterine 18-24 months BF 6 months BF No BF
  5. 5. Maternal Factors <ul><li>High maternal viral load </li></ul><ul><li>CD4 count </li></ul><ul><li>Stage of HIV disease </li></ul><ul><li>Smoking and substance abuse </li></ul><ul><li>STIs and other co infections </li></ul><ul><li>Maternal malnutrition (low vitamin A levels) </li></ul>
  6. 6. Labour and Delivery Factors <ul><li>Genital viral load </li></ul><ul><li>Duration of rupture of membranes </li></ul><ul><li>Invasive delivery procedures (episiotomy, arti ficial rupture of membranes) </li></ul><ul><li>External cephalic version (ECV) </li></ul><ul><li>Chorioamnionitis </li></ul><ul><li>Premature delivery </li></ul><ul><li>Low birth weight </li></ul><ul><li>Mode of delivery </li></ul>
  7. 7. Breastfeeding Factors <ul><li>High breast milk viral load </li></ul><ul><li>Duration of breastfeeding </li></ul><ul><li>Mixed infant feeding </li></ul><ul><li>Breast abscesses, nipple fissures, mastitis </li></ul><ul><li>Poor maternal nutritional status </li></ul><ul><li>Oral disease in the baby (thrush or sores) </li></ul>
  8. 8. Four- Elements for Perinatal HIV Prevention Prevention of HIV in women, especially young women Prevention of unintended pregnancies in HIV-infected women Prevention of transmission from an HIV-infected woman to her infant Support for mother and family Phase 1 Phase 2 Phase 3 Phase 4

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