Part of the First HIV Summit in Bohol, this lecture is on Prevention of Mother to Child Transmission of HIV Infection.

1. PREVENTION OF MOTHER TO CHILD
TRANSMISSION OF HIV INFECTION
Helen V. Madamba, MD MPH-TM FPOGS FPIDSOG
HIV Summit
Bohol
December 3, 2018

2. Disclosure
• OBGYN coordinator, VSMMC HIV
treatment hub, a PMTCT of HIV
Program Implementer
• HIV Coordinator, Cebu Doctors’
University College of Medicine
• Executive Director, The Share A Child
Movement, Inc
• HIV Advocate

3. OBJECTIVES
• To emphasize HIV screening,
counselling and testing during
pregnancy
• To identify the available resources in
the management of pregnant people
living with HIV

4. PHILIPPINES NOW
•  IV drug use
•  gender-based violence
•  teenage pregnancy
•  single mothers
•  new cases of HIV
•  AIDS-related deaths

5. The age group with the highest
proportion of cases has
become younger!
15-24 year
age group
*13% in
1999-2008
*29% in
2011-2018
HIV/AIDS and ART Registry of the Philippines, Department of Health Epidemiology Bureau

6. HIV among Females
HIV/AIDS and ART Registry of the Philippines, Department of Health Epidemiology Bureau

7. HIV+ Pregnant Patients
HIV/AIDS and ART Registry of the Philippines, Department of Health Epidemiology Bureau

8. Youth Forum for HIV
• Primary prevention of HIV infection for key
populations has to start in adolescence
mainly because infections now occur at a
younger age.
• On average, the initiation to sex and drug
use is between 14 and 19 years old.
http://www.unicef.org/philippines/hivaids.html

9. HIV in 6 PH cities may reach 'uncontrollable' rates – DOH
Prevalence rate among males who have sex with males
http://www.rappler.com/nation/89412-hiv-6-philippine-cities-uncontrollable-rates

10. PREVENTION OF MOTHER TO CHILD
TRANSMISSION (PMTCT) OF HIV PROGRAM

11. PREVENTION OF MOTHER TO CHILD TRANSMISSION
(PMTCT) OF HIV PROGRAM
Prong 1. Primary prevention of HIV among women of
child-bearing age.

12. A – abstinence
B – be mutually faithful
C – check your status
D – don’t inject drugs
E – educate yourself and others
early detection
Should teens know about HIV/AIDS?

14. PREVENTION OF MOTHER TO CHILD TRANSMISSION
(PMTCT) OF HIV PROGRAM
Prong 2. Preventing unintended pregnancies among
women living with HIV.

15. Family Planning
• Best protection obtained by:
– Choosing sexual activities that do not allow semen, fluid from
the vagina, or blood to enter the mouth, vagina or anus of the
partner
– Correct and consistent use of condoms during every sexual act
– Reducing the number of partners
POGS Clinical Practice Recommendations on PMTCT

16. PREVENTION OF MOTHER TO CHILD TRANSMISSION
(PMTCT) OF HIV PROGRAM
Prong 3. Preventing HIV transmission among women
living with HIV to her infant.

17. All pregnant women should be offered
HIV counselling and testing routinely.
Key Message:
The fact that you are pregnant is an
evidence of unprotected
penetrative sexual contact which is
a mode of transmission for HIV.
POGS Clinical Practice Recommendations on PMTCT

18. Anti-retroviral (ARV) Drugs
Advantages of Option B+
Option B+: start triple ARVs
as soon as diagnosed and
continue for life
“once ARV is
started,
it is taken for life.”
POGS Clinical Practice Recommendations on PMTCT

19. Cesarean delivery reduces the
risk of HIV transmission to as
much as 50-80%.
Vaginal delivery may be offered:
- those who had ARV treatment
- HIV viral load <1000 copies/ml
- if with ruptured membranes, the time
elapsed should be <4 hours to delivery
POGS Clinical Practice Recommendations on PMTCT

20. INFANT FEEDING
• continue ARV
medications
• replacement
feeding:
acceptable,
feasible,
affordable,
sustainable
and safe
(AFASS)

21. PREVENTION OF MOTHER TO CHILD TRANSMISSION
(PMTCT) OF HIV PROGRAM
Prong 4. Providing treatment, care and support to
women living with HIV, their children and their
families.

22. • Adolescent-friendly health services
• Protection from gender-based violence
• Community empowerment to prevent
discrimination and to reduce stigma
• Family planning and infertility services

23. “HIV prevention will start with me!”

24. #HealthXPH
tweetchat
Healthcare Conversations on Twitter
Saturdays 9:00 p.m. to 10:00 p.m.
@helenvmadamba
https://www.facebook.com/Helen-V-Madamba
http://www.slideshare.net/HelenMadamba
http://helenvmadamba.blogspot.com/

25. PREVENTION OF MOTHER TO CHILD
TRANSMISSION OF HIV INFECTION
Helen V. Madamba, MD MPH-TM FPOGS FPIDSOG
HIV Summit
Bohol
December 3, 2018