Preventing MTCT in Africa: Using New Paradigms - A Dr Besser Presentationmothers2mothers
The document discusses challenges with preventing mother-to-child transmission of HIV in Africa, including high HIV prevalence rates, low access to treatment and care, and difficulties with infant feeding options. It presents data showing that integrated programs that provide testing, counseling and antiretroviral treatment can significantly reduce transmission rates from 25% to as low as 1%, but coverage remains a challenge due to weaknesses in health systems.
1) The document discusses eliminating pediatric HIV/AIDS through preventing mother-to-child transmission (PMTCT). It outlines the four components of the WHO's PMTCT strategy and improvements in reducing new HIV infections among children from 600,000 in 1990 to 370,000 in 2009.
2) While PMTCT programs have expanded, only about half of pregnant women and infants receive antiretroviral drugs. Early diagnosis and lifelong treatment are critical for infants to survive.
3) Goals for HIV care programs include preventing opportunistic infections, early identification and management of complications, and engaging patients in care, treatment and prevention through education and support. With continued progress, the document argues that virtual elimination of pediatric HIV
Dr. Laura Guay, the Foundation’s Vice President of Research, also conducted a journalist training today sponsored by the National Press Foundation, teaching reporters about some of the most misunderstood issues concerning HIV and children
This proposal aims to study infant feeding options among HIV positive mothers in Kano, Nigeria. The introduction provides background on the high rates of mother-to-child HIV transmission in sub-Saharan Africa, noting that breastfeeding accounts for about one-third of transmission. The study will assess the infant feeding practices and choices of HIV positive mothers attending antenatal clinics in Kano. It will determine their knowledge of options, factors influencing choices, and methods chosen. This information could help reduce mother-to-child HIV transmission rates by informing counseling on balancing nutritional benefits of breastfeeding with transmission risks.
Physician and public health researcher Mitchell Besser visited the School of Public Affairs on Oct. 4, delivering a presentation on the prevention of mother-to-child transmission of HIV in Africa. Besser is the founder of Mothers2mothers, an organization that trains mothers with HIV to work in health centers to educate and support pregnant women who are HIV-positive.
Besser talked about "task shifting" some of the responsibilities of health care education from nurses and doctors (that are always in short supply and high demand) to the mothers, and utilizing new technologies such as mobile phones to expand the scope of care.
As an obstetrician and gynecologist, Dr. Besser professional career has been dedicated to the public health needs of women. In 1999, Dr. Besser joined the University of Cape Town's Department of Obstetrics and Gynecology, assisting with the development of services to meet the needs of pregnant women living with HIV and to prevent the transmission of HIV from mothers to their children (PMTCT). Dr. Besser recognized the need for an education and psychosocial support program that would contribute to PMTCT services achieving the best medical and social outcomes. Hoping to fill this void, he founded mothers2mothers in which mothers with HIV are employed to work in health centers, educating and supporting pregnant women and new mothers with HIV; reducing the workload of doctors and nurses and increasing the effectiveness of interventions that reduce the number of babies born with HIV and keep mothers healthy and alive to raise their children. Since its inception in 2001, the program has grown to provide services in more than 680 health care facilities in nine countries in Africa, with more than 3 million contacts with woman each year, reaching 20% of the HIV-positive pregnant women in the world. Dr. Besser has received Global Health Council’s Best Practice Award, Skoll Award for Social Entrepreneurship, Presidential Citizens Award of the United States Government and is an Ashoka and Schwab Fellow. He has presented at TED, appeared on BBC’s Forum and has given a Friday Evening Discourse at the Royal Institution of Great Britain.
1. 27 million people globally were accessing antiretroviral therapy in 2021, representing 75% of all people living with HIV. There were 37.7 million people living with HIV globally in 2021, a 21% increase from 2010. 1.5 million people became newly infected with HIV in 2021.
2. In India, there were an estimated 23 lakh people living with HIV nationally in 2021. Approximately 57,550 new HIV infections occurred in 2021, representing a 48% decrease from 2010. Around 51,000 people died of AIDS-related illnesses in India in 2021.
3. Key data on HIV in India in 2021 include: prevalence of 0.67% among 15-49 year olds,
This document summarizes guidelines for the prevention of mother-to-child transmission (PMTCT) of HIV in Ethiopia. It outlines the epidemiology of HIV in women and children, defining MTCT and PMTCT. Risks of MTCT are highest without intervention, ranging from 20-45%. The national PMTCT strategy includes: primary HIV prevention; preventing unintended pregnancies in HIV+ women; preventing transmission from mother to child; and treatment, care and support of women and families. Key components are counseling and testing, antenatal care, labor/delivery care, postpartum care, infant care including ARV prophylaxis, and lifelong ART for eligible mothers. National guidelines have opted for WHO PMTCT
Preventing MTCT in Africa: Using New Paradigms - A Dr Besser Presentationmothers2mothers
The document discusses challenges with preventing mother-to-child transmission of HIV in Africa, including high HIV prevalence rates, low access to treatment and care, and difficulties with infant feeding options. It presents data showing that integrated programs that provide testing, counseling and antiretroviral treatment can significantly reduce transmission rates from 25% to as low as 1%, but coverage remains a challenge due to weaknesses in health systems.
1) The document discusses eliminating pediatric HIV/AIDS through preventing mother-to-child transmission (PMTCT). It outlines the four components of the WHO's PMTCT strategy and improvements in reducing new HIV infections among children from 600,000 in 1990 to 370,000 in 2009.
2) While PMTCT programs have expanded, only about half of pregnant women and infants receive antiretroviral drugs. Early diagnosis and lifelong treatment are critical for infants to survive.
3) Goals for HIV care programs include preventing opportunistic infections, early identification and management of complications, and engaging patients in care, treatment and prevention through education and support. With continued progress, the document argues that virtual elimination of pediatric HIV
Dr. Laura Guay, the Foundation’s Vice President of Research, also conducted a journalist training today sponsored by the National Press Foundation, teaching reporters about some of the most misunderstood issues concerning HIV and children
This proposal aims to study infant feeding options among HIV positive mothers in Kano, Nigeria. The introduction provides background on the high rates of mother-to-child HIV transmission in sub-Saharan Africa, noting that breastfeeding accounts for about one-third of transmission. The study will assess the infant feeding practices and choices of HIV positive mothers attending antenatal clinics in Kano. It will determine their knowledge of options, factors influencing choices, and methods chosen. This information could help reduce mother-to-child HIV transmission rates by informing counseling on balancing nutritional benefits of breastfeeding with transmission risks.
Physician and public health researcher Mitchell Besser visited the School of Public Affairs on Oct. 4, delivering a presentation on the prevention of mother-to-child transmission of HIV in Africa. Besser is the founder of Mothers2mothers, an organization that trains mothers with HIV to work in health centers to educate and support pregnant women who are HIV-positive.
Besser talked about "task shifting" some of the responsibilities of health care education from nurses and doctors (that are always in short supply and high demand) to the mothers, and utilizing new technologies such as mobile phones to expand the scope of care.
As an obstetrician and gynecologist, Dr. Besser professional career has been dedicated to the public health needs of women. In 1999, Dr. Besser joined the University of Cape Town's Department of Obstetrics and Gynecology, assisting with the development of services to meet the needs of pregnant women living with HIV and to prevent the transmission of HIV from mothers to their children (PMTCT). Dr. Besser recognized the need for an education and psychosocial support program that would contribute to PMTCT services achieving the best medical and social outcomes. Hoping to fill this void, he founded mothers2mothers in which mothers with HIV are employed to work in health centers, educating and supporting pregnant women and new mothers with HIV; reducing the workload of doctors and nurses and increasing the effectiveness of interventions that reduce the number of babies born with HIV and keep mothers healthy and alive to raise their children. Since its inception in 2001, the program has grown to provide services in more than 680 health care facilities in nine countries in Africa, with more than 3 million contacts with woman each year, reaching 20% of the HIV-positive pregnant women in the world. Dr. Besser has received Global Health Council’s Best Practice Award, Skoll Award for Social Entrepreneurship, Presidential Citizens Award of the United States Government and is an Ashoka and Schwab Fellow. He has presented at TED, appeared on BBC’s Forum and has given a Friday Evening Discourse at the Royal Institution of Great Britain.
1. 27 million people globally were accessing antiretroviral therapy in 2021, representing 75% of all people living with HIV. There were 37.7 million people living with HIV globally in 2021, a 21% increase from 2010. 1.5 million people became newly infected with HIV in 2021.
2. In India, there were an estimated 23 lakh people living with HIV nationally in 2021. Approximately 57,550 new HIV infections occurred in 2021, representing a 48% decrease from 2010. Around 51,000 people died of AIDS-related illnesses in India in 2021.
3. Key data on HIV in India in 2021 include: prevalence of 0.67% among 15-49 year olds,
This document summarizes guidelines for the prevention of mother-to-child transmission (PMTCT) of HIV in Ethiopia. It outlines the epidemiology of HIV in women and children, defining MTCT and PMTCT. Risks of MTCT are highest without intervention, ranging from 20-45%. The national PMTCT strategy includes: primary HIV prevention; preventing unintended pregnancies in HIV+ women; preventing transmission from mother to child; and treatment, care and support of women and families. Key components are counseling and testing, antenatal care, labor/delivery care, postpartum care, infant care including ARV prophylaxis, and lifelong ART for eligible mothers. National guidelines have opted for WHO PMTCT
This document provides statistics on the global HIV epidemic in 2018 from UNAIDS as well as information on HIV in India. Some key points:
- 37.9 million people globally were living with HIV in 2018. 1.7 million became newly infected that year while 23.3 million were accessing antiretroviral therapy.
- India has the third largest HIV epidemic in the world. In 2015, the national adult prevalence was 0.26%. Prevalence is highest in certain states like Mizoram (2.04%) and Manipur (1.43%).
- Children account for 6.54% of total PLHIV in India. Early infant diagnosis, appropriate infant feeding and prophylaxis
Emily Chambers Sharpe of the Office of the Global AIDS Coordinator discusses the importance of nutrition and the relationship between ARVs and breastfeeding in preventing mother to child transmission of HIV.
HIV positive mother and her bABY, RISK OF TRANSMISSION, ANTENATAL CARE, INTRA...LalrinchhaniSailo
Globally, an estimated 1.3 million women and girls living with HIV become pregnant each year. In the absence of intervention, the rate of transmission of HIV from a mother living with HIV to her child during pregnancy, labour, delivery or breastfeeding ranges from 15% to 45%. As such, identification of HIV infection should be immediately followed by an offer of linkage to lifelong treatment and care, including support to remain in care and virally suppressed and an offer of partner services.
In 2019, 85% of women and girls globally had access to antiretroviral therapy (ART) to prevent mother-to-child transmission (MTCT). However, high ART coverage levels do not reflect the continued transmission that occurs after women are initially counted as receiving treatment. Achieving retention in care and prevention of incident HIV infections in uninfected populations remain high priorities to reach global elimination targets. Since the global shift to, and accelerated rollout of, highly effective, simplified interventions based on lifelong ART for pregnant women living with HIV, virtual elimination of MTCT – also known as vertical transmission – has been shown to be feasible.
This document discusses HIV/AIDS in pregnancy and prevention of mother-to-child transmission (PMTCT) of HIV in Nigeria. It provides statistics on the burden of HIV in Nigeria and describes the primary mode of HIV transmission as sexual contact. It then focuses on mother-to-child transmission, risk factors that increase transmission during pregnancy and delivery, and the benefits of PMTCT for both mother and infant. It also outlines recommended testing, treatment and prevention strategies used in PMTCT programs.
Module 4 hiv infection & art in childrenDavid Ngogoyo
This document provides an overview of managing HIV infected children. It covers the epidemiology and transmission of HIV in children, the natural progression of disease, diagnosis and staging, prevention and treatment of common HIV conditions, and antiretroviral therapy for children. Key points include mother-to-child transmission being the most common mode of transmission, diagnostic criteria involving virologic tests for children under 18 months and antibody tests after 18 months, and natural history patterns including rapid, intermediate, and slow disease progression in African children.
This was a lecture given during the CME activitiy for POGS Region 7 by the Philippine Infectious Disease Society for Obstetrics and Gynecology (PIDSOG) at Casino Espanyol in Cebu City.
HIV causes AIDS by weakening a person's immune system. It is transmitted through sexual contact, blood and from mother to child. Early diagnosis and treatment can prevent mother-to-child transmission which occurs during pregnancy, childbirth or breastfeeding. With treatment, transmission can be reduced to less than 5%, but without around 15-30% of babies will be infected. Managing HIV in pregnancy requires antiretroviral treatment, nutritional support, monitoring for infections, and strategies to prevent transmission during delivery such as cesarean section instead of breastfeeding.
1. The document discusses prevention of parent-to-child transmission (PPTCT) of HIV, including that transmission can occur during pregnancy, labor, delivery and breastfeeding. It also discusses the importance of PPTCT for preventing pediatric HIV infections.
2. PPTCT services in India aim to detect positive pregnant women and provide them comprehensive services including antiretroviral treatment (ART). The objectives are to detect over 80% of positive women, provide services to over 90%, and ensure over 95% ART compliance for positive women.
3. Care for HIV exposed infants includes care at birth, infant feeding support, antiretroviral prophylaxis, vaccines, cotrimoxazole
This document summarizes guidelines for preventing mother-to-child transmission (PMTCT) of HIV. It discusses how HIV can be transmitted from mother to child during pregnancy, delivery, and breastfeeding. The overall transmission rate without intervention is 15-45%, which can be reduced below 5% with effective interventions. These include voluntary counseling and testing for pregnant women, access to antiretroviral treatment for HIV-positive mothers and their infants, safe delivery practices, and guidance on infant feeding options. The document provides details on testing and treatment recommendations during the antenatal, intrapartum, and postpartum periods to reduce HIV transmission from mother to child.
This document discusses HIV in pregnancy and mother-to-child transmission. It covers epidemiology of HIV in women, transmission routes including vertical transmission, factors affecting mother-to-child transmission, and strategies to prevent mother-to-child transmission including antenatal care, antiretroviral protocols, HAART, and infant feeding options. The minimum package of care and current Zambian protocols are also summarized.
Mother to child transmission of HIV can occur during pregnancy, childbirth, and breastfeeding. The risk is higher if the mother's HIV infection is in an advanced stage, if she is malnourished, has other STDs, or her membranes rupture early. Antiretroviral therapy and cesarean delivery before labor can reduce transmission risk. Exclusive breastfeeding for 6 months poses a lower risk than mixed feeding. India's PMTCT program provides counseling, testing, antiretroviral prophylaxis to pregnant women and newborns to prevent transmission and aims to reduce transmission by 50% by 2010.
The document discusses guidelines for initiating antiretroviral therapy (ART) in children with HIV. It recommends that all children under 12 months with confirmed HIV infection should start ART regardless of clinical stage or CD4 count. For children over 12 months, ART should be initiated for those with WHO Stage 3 or 4 disease or Stage 1 or 2 disease when the CD4 count is below the threshold for that age. The document also provides criteria for presumptively diagnosing severe HIV disease and starting ART in infants under 18 months when virologic testing is unavailable.
The document discusses HIV and pregnancy, noting that HIV can be transmitted from mother to child during pregnancy, labor/delivery, or breastfeeding. It provides information on testing pregnant women for HIV, counseling issues for those who test positive, and measures to reduce mother-to-child transmission including antiretroviral treatment and cesarean delivery. The timing and risk factors for mother-to-child transmission of HIV are also outlined.
Washington Global Health Alliance Discovery Series
Catherine Wilfert, MD [
December 1, 2008
'Global Prevention of Mother to Child Transmission of HIV-1'
The document discusses various aspects of HIV/AIDS including modes of transmission, prevention strategies, and awareness efforts. It outlines that HIV is transmitted through sexual contact, exposure to infected blood or breastmilk, but not through everyday casual contact. Prevention strategies focus on promoting safer sexual behaviors, preventing mother-to-child transmission, blood safety, and universal precautions. Awareness efforts aim to educate high risk groups and the general public through various communication channels.
The document discusses prevention of mother-to-child transmission (PMTCT) of HIV. It outlines the principles of PMTCT, including maternal antiretroviral regimens, management of HIV-exposed infants, and the goals of Tanzania's PMTCT program. Without intervention, 25-45% of infants born to HIV-positive women will acquire HIV. PMTCT strategies aim to reduce this risk to below 5% through antiretroviral treatment or prophylaxis for mothers and infants, safer delivery and infant feeding practices like exclusive breastfeeding for six months.
The document provides information on prevention of parent-to-child transmission (PPTCT) of HIV, including definitions of exclusive breastfeeding, reasons for choosing cup feeding over bottle feeding, factors influencing a woman's choice to breastfeed or use replacement feeding, tests for detecting HIV in infants, risk factors for mother-to-child transmission, and the number of children likely to be infected from an HIV-positive mother. It also summarizes guidelines for antenatal care of HIV-positive women, antiretroviral prophylaxis and treatment, management of labor and delivery, infant feeding options, early infant diagnosis, cotrimoxazole prophylaxis, immunizations and exposed infant care.
Are Public Antenatal Clinics in Blantyre, Malawi, Ready to Offer Services for...Humphrey Misiri
The document summarizes a study that assessed midwives' perceptions of services for preventing mother-to-child transmission of HIV in public antenatal clinics in Blantyre, Malawi. Key findings included:
1) Midwives reported routinely providing HIV prevention messages but few clinics offered condoms or STI screening.
2) While most midwives advised exclusive breastfeeding, some were unsure how to advise HIV-positive women.
3) Facilities often lacked appropriate space, counselors, and supplies to properly provide maternity services and HIV testing.
4) Additional training and support are needed for midwives to adequately care for antenatal women regarding HIV prevention.
The journey towards making elimination of mother to child transmission a real...HopkinsCFAR
The document discusses the journey towards eliminating mother-to-child transmission of HIV (eMTCT) and the contributions of clinical research. It outlines the burden of mother-to-child HIV transmission and the progress made through PMTCT interventions and clinical trials. Landmark trials in Uganda evaluated effective ARV regimens and extended infant prophylaxis, informing WHO guidelines. Ongoing research addresses challenges like adherence and retention through interventions like peer support groups. Further research on new drugs, testing approaches, and integration of services is still needed to achieve eMTCT goals.
This document provides statistics on the global HIV epidemic in 2018 from UNAIDS as well as information on HIV in India. Some key points:
- 37.9 million people globally were living with HIV in 2018. 1.7 million became newly infected that year while 23.3 million were accessing antiretroviral therapy.
- India has the third largest HIV epidemic in the world. In 2015, the national adult prevalence was 0.26%. Prevalence is highest in certain states like Mizoram (2.04%) and Manipur (1.43%).
- Children account for 6.54% of total PLHIV in India. Early infant diagnosis, appropriate infant feeding and prophylaxis
Emily Chambers Sharpe of the Office of the Global AIDS Coordinator discusses the importance of nutrition and the relationship between ARVs and breastfeeding in preventing mother to child transmission of HIV.
HIV positive mother and her bABY, RISK OF TRANSMISSION, ANTENATAL CARE, INTRA...LalrinchhaniSailo
Globally, an estimated 1.3 million women and girls living with HIV become pregnant each year. In the absence of intervention, the rate of transmission of HIV from a mother living with HIV to her child during pregnancy, labour, delivery or breastfeeding ranges from 15% to 45%. As such, identification of HIV infection should be immediately followed by an offer of linkage to lifelong treatment and care, including support to remain in care and virally suppressed and an offer of partner services.
In 2019, 85% of women and girls globally had access to antiretroviral therapy (ART) to prevent mother-to-child transmission (MTCT). However, high ART coverage levels do not reflect the continued transmission that occurs after women are initially counted as receiving treatment. Achieving retention in care and prevention of incident HIV infections in uninfected populations remain high priorities to reach global elimination targets. Since the global shift to, and accelerated rollout of, highly effective, simplified interventions based on lifelong ART for pregnant women living with HIV, virtual elimination of MTCT – also known as vertical transmission – has been shown to be feasible.
This document discusses HIV/AIDS in pregnancy and prevention of mother-to-child transmission (PMTCT) of HIV in Nigeria. It provides statistics on the burden of HIV in Nigeria and describes the primary mode of HIV transmission as sexual contact. It then focuses on mother-to-child transmission, risk factors that increase transmission during pregnancy and delivery, and the benefits of PMTCT for both mother and infant. It also outlines recommended testing, treatment and prevention strategies used in PMTCT programs.
Module 4 hiv infection & art in childrenDavid Ngogoyo
This document provides an overview of managing HIV infected children. It covers the epidemiology and transmission of HIV in children, the natural progression of disease, diagnosis and staging, prevention and treatment of common HIV conditions, and antiretroviral therapy for children. Key points include mother-to-child transmission being the most common mode of transmission, diagnostic criteria involving virologic tests for children under 18 months and antibody tests after 18 months, and natural history patterns including rapid, intermediate, and slow disease progression in African children.
This was a lecture given during the CME activitiy for POGS Region 7 by the Philippine Infectious Disease Society for Obstetrics and Gynecology (PIDSOG) at Casino Espanyol in Cebu City.
HIV causes AIDS by weakening a person's immune system. It is transmitted through sexual contact, blood and from mother to child. Early diagnosis and treatment can prevent mother-to-child transmission which occurs during pregnancy, childbirth or breastfeeding. With treatment, transmission can be reduced to less than 5%, but without around 15-30% of babies will be infected. Managing HIV in pregnancy requires antiretroviral treatment, nutritional support, monitoring for infections, and strategies to prevent transmission during delivery such as cesarean section instead of breastfeeding.
1. The document discusses prevention of parent-to-child transmission (PPTCT) of HIV, including that transmission can occur during pregnancy, labor, delivery and breastfeeding. It also discusses the importance of PPTCT for preventing pediatric HIV infections.
2. PPTCT services in India aim to detect positive pregnant women and provide them comprehensive services including antiretroviral treatment (ART). The objectives are to detect over 80% of positive women, provide services to over 90%, and ensure over 95% ART compliance for positive women.
3. Care for HIV exposed infants includes care at birth, infant feeding support, antiretroviral prophylaxis, vaccines, cotrimoxazole
This document summarizes guidelines for preventing mother-to-child transmission (PMTCT) of HIV. It discusses how HIV can be transmitted from mother to child during pregnancy, delivery, and breastfeeding. The overall transmission rate without intervention is 15-45%, which can be reduced below 5% with effective interventions. These include voluntary counseling and testing for pregnant women, access to antiretroviral treatment for HIV-positive mothers and their infants, safe delivery practices, and guidance on infant feeding options. The document provides details on testing and treatment recommendations during the antenatal, intrapartum, and postpartum periods to reduce HIV transmission from mother to child.
This document discusses HIV in pregnancy and mother-to-child transmission. It covers epidemiology of HIV in women, transmission routes including vertical transmission, factors affecting mother-to-child transmission, and strategies to prevent mother-to-child transmission including antenatal care, antiretroviral protocols, HAART, and infant feeding options. The minimum package of care and current Zambian protocols are also summarized.
Mother to child transmission of HIV can occur during pregnancy, childbirth, and breastfeeding. The risk is higher if the mother's HIV infection is in an advanced stage, if she is malnourished, has other STDs, or her membranes rupture early. Antiretroviral therapy and cesarean delivery before labor can reduce transmission risk. Exclusive breastfeeding for 6 months poses a lower risk than mixed feeding. India's PMTCT program provides counseling, testing, antiretroviral prophylaxis to pregnant women and newborns to prevent transmission and aims to reduce transmission by 50% by 2010.
The document discusses guidelines for initiating antiretroviral therapy (ART) in children with HIV. It recommends that all children under 12 months with confirmed HIV infection should start ART regardless of clinical stage or CD4 count. For children over 12 months, ART should be initiated for those with WHO Stage 3 or 4 disease or Stage 1 or 2 disease when the CD4 count is below the threshold for that age. The document also provides criteria for presumptively diagnosing severe HIV disease and starting ART in infants under 18 months when virologic testing is unavailable.
The document discusses HIV and pregnancy, noting that HIV can be transmitted from mother to child during pregnancy, labor/delivery, or breastfeeding. It provides information on testing pregnant women for HIV, counseling issues for those who test positive, and measures to reduce mother-to-child transmission including antiretroviral treatment and cesarean delivery. The timing and risk factors for mother-to-child transmission of HIV are also outlined.
Washington Global Health Alliance Discovery Series
Catherine Wilfert, MD [
December 1, 2008
'Global Prevention of Mother to Child Transmission of HIV-1'
The document discusses various aspects of HIV/AIDS including modes of transmission, prevention strategies, and awareness efforts. It outlines that HIV is transmitted through sexual contact, exposure to infected blood or breastmilk, but not through everyday casual contact. Prevention strategies focus on promoting safer sexual behaviors, preventing mother-to-child transmission, blood safety, and universal precautions. Awareness efforts aim to educate high risk groups and the general public through various communication channels.
The document discusses prevention of mother-to-child transmission (PMTCT) of HIV. It outlines the principles of PMTCT, including maternal antiretroviral regimens, management of HIV-exposed infants, and the goals of Tanzania's PMTCT program. Without intervention, 25-45% of infants born to HIV-positive women will acquire HIV. PMTCT strategies aim to reduce this risk to below 5% through antiretroviral treatment or prophylaxis for mothers and infants, safer delivery and infant feeding practices like exclusive breastfeeding for six months.
The document provides information on prevention of parent-to-child transmission (PPTCT) of HIV, including definitions of exclusive breastfeeding, reasons for choosing cup feeding over bottle feeding, factors influencing a woman's choice to breastfeed or use replacement feeding, tests for detecting HIV in infants, risk factors for mother-to-child transmission, and the number of children likely to be infected from an HIV-positive mother. It also summarizes guidelines for antenatal care of HIV-positive women, antiretroviral prophylaxis and treatment, management of labor and delivery, infant feeding options, early infant diagnosis, cotrimoxazole prophylaxis, immunizations and exposed infant care.
Are Public Antenatal Clinics in Blantyre, Malawi, Ready to Offer Services for...Humphrey Misiri
The document summarizes a study that assessed midwives' perceptions of services for preventing mother-to-child transmission of HIV in public antenatal clinics in Blantyre, Malawi. Key findings included:
1) Midwives reported routinely providing HIV prevention messages but few clinics offered condoms or STI screening.
2) While most midwives advised exclusive breastfeeding, some were unsure how to advise HIV-positive women.
3) Facilities often lacked appropriate space, counselors, and supplies to properly provide maternity services and HIV testing.
4) Additional training and support are needed for midwives to adequately care for antenatal women regarding HIV prevention.
The journey towards making elimination of mother to child transmission a real...HopkinsCFAR
The document discusses the journey towards eliminating mother-to-child transmission of HIV (eMTCT) and the contributions of clinical research. It outlines the burden of mother-to-child HIV transmission and the progress made through PMTCT interventions and clinical trials. Landmark trials in Uganda evaluated effective ARV regimens and extended infant prophylaxis, informing WHO guidelines. Ongoing research addresses challenges like adherence and retention through interventions like peer support groups. Further research on new drugs, testing approaches, and integration of services is still needed to achieve eMTCT goals.
Similar to Session-16-HIV-and-Replacement-Feeding-revised-2012.ppt (20)
The Importance of Black Women Understanding the Chemicals in Their Personal C...bkling
Certain chemicals, such as phthalates and parabens, can disrupt the body's hormones and have significant effects on health. According to data, hormone-related health issues such as uterine fibroids, infertility, early puberty and more aggressive forms of breast and endometrial cancers disproportionately affect Black women. Our guest speaker, Jasmine A. McDonald, PhD, an Assistant Professor in the Department of Epidemiology at Columbia University in New York City, discusses the scientific reasons why Black women should pay attention to specific chemicals in their personal care products, like hair care, and ways to minimize their exposure.
R3 Stem Cell Therapy: A New Hope for Women with Ovarian FailureR3 Stem Cell
Discover the groundbreaking advancements in stem cell therapy by R3 Stem Cell, offering new hope for women with ovarian failure. This innovative treatment aims to restore ovarian function, improve fertility, and enhance overall well-being, revolutionizing reproductive health for women worldwide.
Sectional dentures for microstomia patients.pptxSatvikaPrasad
Microstomia, characterized by an abnormally small oral aperture, presents significant challenges in prosthodontic treatment, including limited access for examination, difficulties in impression making, and challenges with prosthesis insertion and removal. To manage these issues, customized impression techniques using sectional trays and elastomeric materials are employed. Prostheses may be designed in segments or with flexible materials to facilitate handling. Minimally invasive procedures and the use of digital technologies can enhance patient comfort. Education and training for patients on prosthesis care and maintenance are crucial for compliance. Regular follow-up and a multidisciplinary approach, involving collaboration with other specialists, ensure comprehensive care and improved quality of life for microstomia patients.
The best massage spa Ajman is Chandrima Spa Ajman, which was founded in 2023 and is exclusively for men 24 hours a day. As of right now, our parent firm has been providing massage services to over 50,000+ clients in Ajman for the past 10 years. It has about 8+ branches. This demonstrates that Chandrima Spa Ajman is among the most reasonably priced spas in Ajman and the ideal place to unwind and rejuvenate. We provide a wide range of Spa massage treatments, including Indian, Pakistani, Kerala, Malayali, and body-to-body massages. Numerous massage techniques are available, including deep tissue, Swedish, Thai, Russian, and hot stone massages. Our massage therapists produce genuinely unique treatments that generate a revitalized sense of inner serenely by fusing modern techniques, the cleanest natural substances, and traditional holistic therapists.
CHAPTER 1 SEMESTER V COMMUNICATION TECHNIQUES FOR CHILDREN.pdfSachin Sharma
Here are some key objectives of communication with children:
Build Trust and Security:
Establish a safe and supportive environment where children feel comfortable expressing themselves.
Encourage Expression:
Enable children to articulate their thoughts, feelings, and experiences.
Promote Emotional Understanding:
Help children identify and understand their own emotions and the emotions of others.
Enhance Listening Skills:
Develop children’s ability to listen attentively and respond appropriately.
Foster Positive Relationships:
Strengthen the bond between children and caregivers, peers, and other adults.
Support Learning and Development:
Aid cognitive and language development through engaging and meaningful conversations.
Teach Social Skills:
Encourage polite, respectful, and empathetic interactions with others.
Resolve Conflicts:
Provide tools and guidance for children to handle disagreements constructively.
Encourage Independence:
Support children in making decisions and solving problems on their own.
Provide Reassurance and Comfort:
Offer comfort and understanding during times of distress or uncertainty.
Reinforce Positive Behavior:
Acknowledge and encourage positive actions and behaviors.
Guide and Educate:
Offer clear instructions and explanations to help children understand expectations and learn new concepts.
By focusing on these objectives, communication with children can be both effective and nurturing, supporting their overall growth and well-being.
About this webinar: This talk will introduce what cancer rehabilitation is, where it fits into the cancer trajectory, and who can benefit from it. In addition, the current landscape of cancer rehabilitation in Canada will be discussed and the need for advocacy to increase access to this essential component of cancer care.
Get Covid Testing at Fit to Fly PCR TestNX Healthcare
A Fit-to-Fly PCR Test is a crucial service for travelers needing to meet the entry requirements of various countries or airlines. This test involves a polymerase chain reaction (PCR) test for COVID-19, which is considered the gold standard for detecting active infections. At our travel clinic in Leeds, we offer fast and reliable Fit to Fly PCR testing, providing you with an official certificate verifying your negative COVID-19 status. Our process is designed for convenience and accuracy, with quick turnaround times to ensure you receive your results and certificate in time for your departure. Trust our professional and experienced medical team to help you travel safely and compliantly, giving you peace of mind for your journey.
At Malayali Kerala Spa Ajman, Full Service includes individualized care for every client. We specifically design each massage session for the individual needs of the client. Our therapists are always willing to adjust the treatments based on the client's instruction and feedback. This guarantees that every client receives the treatment they expect.
By offering a variety of massage services, our Ajman Spa Massage Center can tackle physical, mental, and emotional illnesses. In addition, efficient identification of specific health conditions and designing treatment plans accordingly can significantly enhance the quality of massaging.
At Malayali Kerala Spa Ajman, we firmly believe that everyone should have the option to experience top-quality massage services regularly. To achieve that goal we offer cheap massage services in Ajman.
If you are interested in experiencing transformative massage treatment at Malayali Kerala Spa Ajman, you can use our Ajman Massage Center WhatsApp Number to schedule your next massage session.
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This particular slides consist of- what is hypotension,what are it's causes and it's effect on body, risk factors, symptoms,complications, diagnosis and role of physiotherapy in it.
This slide is very helpful for physiotherapy students and also for other medical and healthcare students.
Here is the summary of hypotension:
Hypotension, or low blood pressure, is when the pressure of blood circulating in the body is lower than normal or expected. It's only a problem if it negatively impacts the body and causes symptoms. Normal blood pressure is usually between 90/60 mmHg and 120/80 mmHg, but pressures below 90/60 are generally considered hypotensive.
End-tidal carbon dioxide (ETCO2) is the level of carbon dioxide that is released at the end of an exhaled breath. ETCO2 levels reflect the adequacy with which carbon dioxide (CO2) is carried in the blood back to the lungs and exhaled.
Non-invasive methods for ETCO2 measurement include capnometry and capnography. Capnometry provides a numerical value for ETCO2. In contrast, capnography delivers a more comprehensive measurement that is displayed in both graphical (waveform) and numerical form.
Sidestream devices can monitor both intubated and non-intubated patients, while mainstream devices are most often limited to intubated patients.
Unlocking the Secrets to Safe Patient Handling.pdfLift Ability
Furthermore, the time constraints and workload in healthcare settings can make it challenging for caregivers to prioritise safe patient handling Australia practices, leading to shortcuts and increased risks.
3. At the end of the session the participants
will be able to:
1. Discuss the importance of counseling HIV
positive women on infant feeding options;
2. Discuss the benefits of BF to newborns and to
mother
3. Enumerate the different factors associated
with HIV transmission through BF
4. Identify the recommended feeding options for
different scenarios
5. Discuss how to stop BF
6. Determine the feeding options after cessation
of BF
4. Global
summary
of the
HIV/AIDS
epidemic
Western Europe
520,000 – 680,000
North Africa & Middle
East
470,000 – 730,000
Sub-Saharan Africa
27.0 – 29.2 million
Eastern Europe
& Central Asia
1.2 – 1.8 million
South &
South-East Asia
5.6 – 9.2 million
Australia
& New Zealand
12,000 – 18,000
North America
790,000 – 1.2 million
Caribbean
350,000 – 590,000
Latin America
1.3 – 1.9 million
East Asia & Pacific
800,000 – 1.3 million
Adults and children estimated to be living with HIV and AIDS
as of end of 2011 Total: 33 (32.6 – 38.1) million
HIV & AIDS Situationer
Office of the WHO Representative in the Philippines
5. Office of the WHO Representative in the Philippines
Is HIV Problem in the Philippines Real?
The Current HIV
Situation
7. HIV Situation in the
Philippines
Estimated number of People
living with HIV 2011 (15-49 yr
old): 19,022
7,884 cumulative cases reported
(1984 – 2011)
By 2015, estimated HIV
population: 35,941
8. 5yrs ago: 210 new cases/yr
This year: 1500 new cases
In 5yrs: 9,800 new cases/yr
Total: 35,000 PLHIV
9. DEMOGRAPHIC FIGURES 1984-2012
Demographic Data January 2012 Cumulative Data: 1984- 2012
Total Reported Cases 212 8,576
Asymptomatic Cases 208 7,601
AIDS Cases 4 975
Males 203 7,093
Females 9 1,472
Youth 15-24yo 57 1,974
Children < 15yo 1 59
Reported Deaths due to
AIDS
1 342
10. Office of the WHO Representative in the Philippines
Sentinel
Sites
Baguio City
Angeles City
Quezon City
Pasay City
Iloilo City
Cebu City
Cagayan de Oro City
Davao City
Gen. Santos City
Zamboanga City
In 2007…
National adult HIV
prevalence = 0.0168%
Estimated Number of
PLHIV: 7,490
in 2009…
10x increase!
11. Treatment Hubs 13 (+ 3)
Gov. Celestino Gallares
Mem Hosp (VII)
Jose B. Lingad
Memorial Medical
Center (III)
Cagayan Valley
Medical Center (II)
Makati Med Cntr
The Medical City
12. Office of the WHO Representative in the Philippines
Results
• HIV epidemic in the Philippines
expanding
• 10x increase in the number of HIV +
cases
• Evidence of rapid growth rate in some
geosites, among specific most-at-risk
groups (MSM and PWID)
• NO Most-at-risk group is off the hook
• 50% of infection transmitted in the past 5
months (BED Assay)
13. Office of the WHO Representative in the Philippines
2009: TWO new cases a day!
Average Number of Cases per Month
2007: One new case a day
2000: One new case every
3 days
N A T I O N A L E P I D E M I O L O G Y C E N T E R
2011 : 5-6 new cases a day!
14. HIV Transmission
• Exchange of HIV-infected body fluid such as
semen, vaginal fluid or blood during unprotected
sexual intercourse
• HIV-infected blood transfusions
• Percutaneous (contaminated needles or other
sharp instruments) or mucous membrane exposure
to contaminated blood and other body fluids
• Mother to Child Transmission (MTCT) during
pregnancy, labor and delivery Breastfeeding
15. TRANSMISSION
Transmission Risk:
Unprotected vaginal intercourse M to F 0.1%
Unprotected vaginal intercourse F to M 0.05%
Unprotected anal intercourse 0.56%
Needle share/ IV drug use 67%
Needle stick 0.3%
Mother to child transmission 13-48%
Blood products 90%
MMWRJanuary 21, 2005 / 54(RR02);1-20adapted
16. TREATMENT: Drugs to treat HIV
Antiretroviral drugs or ARVs
use to reduce the amount of HIV in the body
given at the end of pregnancy and at the time of
delivery
Combination antiretroviral therapy has been
shown to be more effective than monotherapy (3
drugs given whenever possible)
Drugs
azidothymidine (AZT)
zidovudine (ZDV)
nevirapine
17. Philippine HIV/AIDS Registry
January 1984-Nov 2011 (N= 8,096)
Reported modes of Transmission cases
Sexual Transmission/Contact 7,408
Blood/Blood products 20
Injecting drug use 235
Needle prick injuries 3
Mother-to-Child 55
No Data Available 375
18. Mother-To-Child Transmission
(MTCT) of HIV
Young children who get HIV are usually
infected through their mother
- during pregnancy across the placenta
- at the time of labour and birth through
blood and secretions
- through breastfeeding
17/3
19. Estimated risk and timing of MCTC
transmission of HIV in the absence of interventions
Timing of MTCT of HIV Transmission Rate
During pregnancy 5-10%
During labour and delivery 10-15%
During breastfeeding 5-20%
_____________________________________________________________________
Overall without breastfeeding 15-25%
Overall with breastfeeding to 6 months 20-35%
Overall with breastfeeding to 18–24 months 30-45%
17/4
20. Assume prevalence of
HIV infection among
women in the area is
20 %
Q. How many of these
women are likely to be
HIV-positive ?
100 mothers and babies
21. Of the 100 mothers and babies
(Only 20 mothers may have HIV)
17/6
++ + + +
+ + +
++ + +
+ + + + +
+ + +
If the prevalence of HIV infection is 20%, 20% of 100 = 20
22. The MCTC during
pregnancy is 15-25%
(Using 25%) ,
how many of these
infants were infected
before or during
delivery ?
20 mothers are likely to be HIV positive
Timing of MTCT of HIV Transmission Rate
During pregnancy 5-10%
During labour and delivery 10-15%
During breastfeeding 5-20%
________________________________________________
Overall without breastfeeding 15-25%
Overall with breastfeeding to 6 months 20-35%
Overall with breastfeeding to 18–24 months 30-45%
++ + + +
+ + +
+++ +
+ + + + +
+ + +
23. Of the 20 mothers who may have the HIV...
ONLY 5 infants are likely to be infected during pregnancy and
delivery
17/6
+
+ + + +
+ + +
++ + +
+ + + + +
+ + +
25% of 20 = 5
24. The transmission rate
during breastfeeding is
5-20% …
(using 15%) , assuming
all babies are breastfed
how many will be
infected ?
20 mothers who are likely to be HIV positive
Timing of MTCT of HIV Transmission Rate
During pregnancy 5-10%
During labour and delivery 10-15%
During breastfeeding 5-20%
________________________________________________
Overall without breastfeeding 15-25%
Overall with breastfeeding to 6 months 20-35%
Overall with breastfeeding to 18–24 months 30-45%
++ + + +
+ + +
+++ +
+ + + + +
+ + +
25. 100 mothers and babies
Only 20 mothers may have HIV
(About 3 of the infants of HIV positive mothers are likely to be infected by
breastfeeding)
17/6
++ + + +
+ + +
++ + +
+ + + + +
+ + +
15% of 20 = 3
26. Factors which affect
mother-to-child transmission of HIV
Recent infection with HIV
Severity of disease
Sexually transmitted infections
Obstetric procedures
Duration of breastfeeding
Exclusive breastfeeding or mixed feeding
Condition of the breasts
Condition of the baby’s mouth
17/13
27. Recent infection with HIV
Woman infected with HIV during
pregnancy or while breastfeeding
higher levels of virus in her blood
infant is more likely to be infected
Unprotected extramarital sex exposes
men to infection with HIV
28. Severity of HIV infection
Mother is ill with HIV-related disease or
AIDS
Mother not treated with drugs
More virus in the body
= Transmission to the baby is more likely
29. Duration of breastfeeding
Virus can be transmitted any time
during breastfeeding
The longer the duration of
breastfeeding, the greater the risk of
transmission
30. Exclusive breastfeeding or mixed feeding
Risk of transmission is greater if
infant given any other foods or drinks
Risk is less if exclusive breastfeeding
Other foods may cause diarrhea and
damage the gut
31. Condition of the breasts
Nipple fissure, mastitis or breast
abscess may increase risk of HIV
transmission
Good breastfeeding technique helps
• prevent these conditions
• reduce transmission of HIV
Condition of the baby’s mouth
• Mouth sores or thrush may enter the
damaged skin
32. 1. Mothers known to be HIV-infected and whose
infants are HIV uninfected or of unknown HIV status.
• This infant feeding option can be observed in the following
situations:
• The mother was started on ARV treatment.
• The mother received zidovudine (AZT) as prophylaxis
during pregnancy and that the baby will be given daily
dose of nevirapine up to 1 week after all exposure to
breastmilk has ended.
• (Dose of Nevirapine (once daily): Birth-6weeks if
<2,500gm – 10mg , if > 2,500 gm – 15 mg ; > 6
weeks-6 months – 20mg; >6-9months – 30mg ;
>9months to end of breastfeeding – 40mg)
33. 2. Mothers known to be HIV infected with an
HIV positive child
• Since the child is already known to be (+),
preventing transmission is no longer a
concern in determining the appropriate
feeding option.
• For this scenario, the best feeding option is
exclusive BF for 6 months and continue BF
up to 12 months of age
34. Counselling for infant feeding
in relation to HIV
Pregnant or recently-delivered woman
in contact with the health services
Unknown
HIV status
Tested
negative
Tested
positive
Encourage
testing
Counsel and
encourage
breastfeeding
Counsel on
infant feeding
Discuss all
options
available
18/2
35. • a. safe water and sanitation are assured
at the household level and in the
community
• b. the mother, or other caregiver can
reliably provide sufficient infant formula
milk to support normal growth and
development of the infant
CONDITIONS when to give
Replacement Feeding to infant with
HIV:
36. c the mother or caregiver can prepare it
cleanly and frequently enough so that it
is safe and carries a low risk of diarrhoea
and malnutrition.
d. the mother or caregiver can, in the
first six months, exclusively give infant
formula milk
37. • d. the mother or caregiver can, in the
first six months, exclusively give infant
formula milk
• e. the family is supportive of this
practice
• f. the mother or caregiver can access
health care that offers comprehensive
child health services.
38. • These descriptions are intended to
give simpler and more explicit
options and meaning to the concept
of AFASS (acceptable, feasible,
affordable, sustainable, safe)
39. Infant feeding options from
0-6 months
for HIV-positive women
Infant feeding options from 0-6 months
Replacement feeding
when requirements
are fulfilled
• Commercial infant
formula
• Home modified
animal milk with a
micronutrient
supplement
Exclusive
breastfeeding
Other breast-milk
options:
• Expression and heat-
treatment
• [Milk banks]
Early cessation
when RF
requirements
are fulfilled
18/3
40. ADVANTAGES of Exclusive
breastfeeding for an HIV-infected mother
Breast milk is the perfect food for babies
- complete nutrition including water
- no need for any liquid or food
Breast milk gives protection against
common childhood infections, especially
diarrhea and pneumonia
Breast milk is free, always available and
does not need any special preparation
41. Advantages of exclusive breastfeeding for
an HIV-infected mother
Exclusive breastfeeding reduces
the risk of HIV transmission,
compared to mixed feeding
Exclusive breastfeeding helps
mothers recover from childbirth
and protects them from getting
pregnant too soon
42. DISADVANTAGES of exclusive
breastfeeding for an HIV-infected mother
As long as the mother breastfeeds, her
baby is exposed to HIV
People may pressure mother to mix feed
which increases the risk of HIV and other
infections
Mother will need support to exclusively
breastfeed until it is possible for her to
use another feeding option
43. Early cessation of breastfeeding
Reduces the risk of HIV transmission
- by reducing the length of time the
infant is exposed to the virus in breast
milk
- for HIV+ = 12 months is maximum
length of time to breastfed; whereas for
healthy babies continue up to 2 years
44. Early cessation of breastfeeding
Mothers may consider other breast milk
substitute such as expressing and heat-
treating breast milk from six months
onwards
45. How to stop breastfeeding
• HIV infected mothers who decided to stop BF
at any time should discontinue it gradually
within a month.
• Infants who are receiving prophylaxis (daily
Nevirapine) should continue taking the drugs
up to one week after the cessation of
breastmilk exposure.
• For HIV infected mothers who decided to stop
BF, the health provider must counsel them on
other infant feeding alternatives.
46. Breastfeeding by another
woman who is HIV-negative
Wet nursing – a woman breastfeeding
a baby to whom she did not give
birth
Donor breast milk – milk expressed by
another woman for another baby
47. Pointers about wet-nursing
A woman breastfeeding another infant
need to have sufficient rest, food and
water
Baby’s own mother should provide as
much care as possible to the child by
cuddling, changing, washing, massaging,
and giving other foods
48. Pointers about wet-nursing
To protect the baby from HIV, wet-nurse
must be HIV-negative
Wet-nurse should protect self from HIV
infection the entire time she is breastfeeding
• Not having sex or using condom
• Have sex with only one partner who is
also faithful to her
• Not sharing razors, needles or other
piercing objects
49. Heat-treated expressed milk
Heat-treated breast milk is another option to
consider if
• Mother wishes to give her baby her own
milk
• Alternative milks are too expensive
• Sick or low-birth-weight infants are more
at risk from artificial feeding
50. Heat-treated expressed milk
Heat-treatment destroys HIV in breast milk
Heat-treatment reduces the level of some
anti-infective components of breast milk
Heat-treated milk remains superior to
breast-milk substitute
51. HOW to heat-treat and store breast milk
Before heating gather the following
Clean containers with wide necks and
covers, enough to store the milk
A small pot to heat the milk
A large container of cool water
A small cup for feeding the baby
Fuel to heat the milk
Soap and clean water to wash the
equipment
52. How to heat-treat and store breast milk
Follow these steps
- Wash all the pots, cups and containers with soap
and water
- Only heat enough expressed milk for one feed
- Place container with breastmilk inside a wider
pot with boiling water . When the breastmilk is
rolling boil, remove and
- Place the pot in a container of cold water so
that it cools quickly or let the milk stand until it
cools
- Store the boiled milk in clean, covered container
53. 1. ADVANTAGES
Giving only formula carries no risk of
transmitting HIV to the baby
Most of the nutrients a baby needs have
already been added to the formula.
Other responsible family members can
help feed the baby.
ADVANTAGES AND DISADVANTAGES OF
COMMERCIAL INFANT FORMULA
54. II. DISADVANTAGES of artificial formula
Formula does not contain antibodies that
protect a baby from infections.
A formula-fed baby is more likely to get
seriously sick from diarrhoea, chest
infections and malnutrition, especially if the
formula is not prepared correctly.
A mother should stop breastfeeding
completely or the risk of transmitting HIV
will continue.
55. People may wonder why a mother is
using formula instead of breastfeeding,
and this could cause them to suspect
she is HIV- positive.
Mother needs fuel, clean water, utensils,
soap etc.
Time consuming
Expensive
Have to teach baby to drink from cup
Mom may get pregnant soon
DISADVANTAGES OF COMMERCIAL FORMULA
56. Summary
If a mother who is HIV-positive decides to
breastfeed as the best option, she should
be supported to establish and maintain it
If a mother breastfeeds, she should make
sure that her infant is well-attached to the
breast, to prevent nipple fissure and
mastitis, which may increase the risk of
transmission of HIV
57. Summary
A mother who is HIV-positive should
breastfeed exclusively, no other foods or
fluids
Other breast milk options include :
exclusive breastfeeding and stopping early,
expression, and heat-treatment of breast
milk
58. “HIV-infected mothers should receive
counselling which includes provision of
general information about the risks and
benefits of various infant feeding
options, and specific guidance in
selecting the option most likely to be
suitable for their situation. Whatever a
mother decides, she should be
supported in her choice”
WHO 2010 Guideline on HIV and Infant Feeding
59.
60. CASE STUDY NO. 1
• Marian, 28 year old HIV positive
woman, has delivered a baby boy.
During her pregnancy, she was given
AZT as early as 28 weeks of pregnancy.
• As part of post-delivery counseling,
what advice will you give to Marian on
infant feeding?
61. • During post-delivery counseling, the health provider should
encourage Marian to BF her baby exclusively provided that the
baby will be given daily dose of nevirapine.
• The health provider can explain to Marian that there is risk of
transmission of the HIV virus through BF. However, this risk can
be reduced by providing ARV prophylaxis to her baby since she
has already taken AZT during pregnancy.
• The health provider should also advise her that in case she
would stop BF for whatever cause, daily dose of nevirapine
taken by the baby can only be discontinued one week after the
cessation of BF
62. CASE STUDY NO. 2
• Helen, 32 year old positive woman that is on
zidovudine, lamivudine and nevirapine, came
to your clinic as part of her antenatal check
up. She is pregnant at 37 weeks age of
gestation. She asked you as her attending
physician if she can breastfeed her baby right
after delivery. Helen said that she has
browsed the internet and found out that HIV
can be transmitted through breast milk.
• What advice will you give to Helen regarding
her concerns?
63. • The health provider can explain to Helen that
there is risk of transmission of HIV to the
baby because the HIV virus in CD4 cells is
present in breast milk.
• However, antiretroviral drugs can reduce
the risk of transmission.
• The health provider can assure Helen that
she can breastfeed her baby after delivery as
long as she will continue taking her
antiretroviral drugs.
64. CASE STUDY NO. 3
• Micah, 26 year old woman, is breastfeeding her
4 month old baby when she found out that she
is HIV positive. She submitted herself and her
3 month old baby to HIV testing after the result
of the HIV test of her husband turned out to be
positive. Her baby also turned out to be
positive. During post HIV test counseling,
Micah asked if she can still continue
breastfeeding her baby.
• How will you advise Micah regarding her
concerns.
65. • Since both Micah and her baby are known to be HIV
positive, risk of transmission is no longer a major
concern.
• In this case, the health provider can advise Micah to
continue breastfeeding exclusively up to 6 months
and at six months, introduce complementary foods.
• Breastfeeding can be continued like the
recommendation for the general population which is
up to 2 years of age.