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Unit 2 mtct and prevention strategies
 

Unit 2 mtct and prevention strategies

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    Unit 2 mtct and prevention strategies Unit 2 mtct and prevention strategies Presentation Transcript

    • Factors that increase transmission and strategies to reduce transmission
    • 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
    • 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.
    • 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
    • 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)
    • 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
    • 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)
    • 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