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Unit 2 mtct and prevention strategies
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Unit 2 mtct and prevention strategies



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  • 1. Factors that increase transmission and strategies to reduce transmission
  • 2. Session Objective and content
    • 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
    • Content
        • Timing of transmission
        • Factors influencing transmission (risk factors)
        • Interventions to reduce transmission – 4 elements of perinatal HIV prevention
  • 3. Mother-to-Child HIV Transmission
    • MTCT is responsible for over 90% of childhood HIV infections.
    • MTCT can take place:
      • During pregnancy
      • During labour and delivery
      • Postnatal due to breastfeeding
    • Overall, the transmission rate is 40% without interventions.
  • 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. Maternal Factors
    • High maternal viral load
    • CD4 count
    • Stage of HIV disease
    • Smoking and substance abuse
    • STIs and other co infections
    • Maternal malnutrition (low vitamin A levels)
  • 6. Labour and Delivery Factors
    • Genital viral load
    • Duration of rupture of membranes
    • Invasive delivery procedures (episiotomy, arti ficial rupture of membranes)
    • External cephalic version (ECV)
    • Chorioamnionitis
    • Premature delivery
    • Low birth weight
    • Mode of delivery
  • 7. Breastfeeding Factors
    • High breast milk viral load
    • Duration of breastfeeding
    • Mixed infant feeding
    • Breast abscesses, nipple fissures, mastitis
    • Poor maternal nutritional status
    • Oral disease in the baby (thrush or sores)
  • 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