Taking Antiretroviral Treatment To Protect Your Baby
Taking treatment properly can reduce the risk of your baby being born with HIV to less than 1%.
If you knew that you were HIV-positive before you got pregnant, you may be taking treatment already. If you are not, talk to a healthcare professional about starting treatment as soon as possible.
If you found out that you living with HIV during your pregnancy, it is recommended that you start treatment as soon as possible and continue taking it every day for life.
Your baby will also be given treatment for four to six weeks after they are born to help prevent an HIV infection developing.
Prevalence Of Mtct Of Hiv In Ethiopia
The prevalence of MTCT of HIV among the included studies ranges from a minimum of 4.16% in Hawassa University Referral and Yirgalem general hospital, SNNPR to a maximum of 15.7% in DilChora referral hospital, Dire Dawa city administration . A prevalence of 5.9% in East and West Gojjam zones, Amhara region , 9.6% in St. Luke Hospital, Woliso town, Oromia region , 10% in Gondar University referral hospital, Amhara region , and 10.1% in South Gondar zone, Amhara region were also observed. Furthermore, the pooled prevalence of MTCT of HIV in Ethiopia was 9.93% . The heterogeneity test showed presence of heterogeneity, I2=86.8%, p-value=< 0.001. However, non-significant publication bias was detected, p-value=0.143.
Questions To Ask Your Doctor
If you have been infected with HIV or are at risk of infection, you probably have some questions about the condition and how it can affect your baby.
You may find it helpful to jot down questions as they arisethat way, when you talk to your doctor, you can be sure that all of your concerns are addressed.
Here are some questions to get you started:
- Should I get tested for HIV?
- What can I do to prevent infection?
- Im infected. Is there any way to prevent passing it on to my baby?
- What steps can we take if my baby does get infected?
- Whats the long-term outlook for a baby with HIV?
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Symptoms Of Hiv/aids In Children
Children living with HIV are frequently slow to reach important developmental milestones such as crawling, walking and speaking. Many do not gain weight or grow normally. Like adults living with HIV, children living with HIV can develop life-threatening opportunistic infections. The type of infections is different for children and adults, with serious bacterial infections occurring more often among children.
What Are The Risk Factors For Transmitting Hiv During Pregnancy
If a woman is infected with HIV, her risk of transmitting the virus to her baby is reduced if she stays as healthy as possible. According to the March of Dimes, new treatments can reduce the risk of a treated mother passing HIV to her baby to a 2 percent or less chance.Factors which increase the risk of transmission include:
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Telling Health Professionals About Your Hiv Status
It is important to tell your doctor, obstetrician or midwife about your HIV status as early as you can .
Telling your health team, helps to talk through any concerns you may have and ensure you receive treatment before that suits your needs, and is safe throughout pregnancy and after your baby is born.
Also, if your medical team knows about your HIV status, they can take steps to minimise the risk of accidental transmission during any medical procedures.
Frequency Of Perinatal Hiv Transmission
Without treatment, 25 to 30% of babies born to a mother living with HIV will get HIV. However, if mothers are aware of their HIV infection and treated along with their infants, the chances of the infant getting HIV are less than 2%.
In Minnesota, the rate of perinatal transmission decreased with the availability of testing and treatment for pregnant women and their babies. During 1982-1994 the transmission rate was 25%, but has since decreased to less than 1.9% among babies born in 2015-2017.
In the U.S., through December 31, 2015, 11,600 cases of perinatal transmission have been reported. In Minnesota, a total of 12 cases of perinatal transmission have been reported since 1999.
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Pregnancy Childbirth & Breastfeeding And Hiv
- A pregnant woman living with HIV can pass on the virus to her baby during pregnancy, childbirth and through breastfeeding.
- If you are a woman living with HIV, taking antiretroviral treatment correctly during pregnancy and breastfeeding can virtually eliminate the risk of passing on the virus to your baby.
- Attending antenatal appointments means you can get tested for HIV and if needed receive treatment and medical advice to help keep you and your baby healthy.
If You Choose To Breastfeed:
If you are on treatment with an undetectable viral load and choose to breastfeed your baby, then see your doctor before you start. Your clinic team can help you make it as safe as possible for your baby, but it will not be as safe as using formula.
You should breastfeed your baby for as short a time as possible, and the baby should only have breastmilk for the first 6 months, and not formula or cows milk too.
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Reducing The Risk Of Passing Hiv To Your Baby
If you have HIV, you can reduce the risk of passing it to your baby by:
- taking antiretroviral drugs during pregnancy, even if you don’t need HIV treatment for your own health
- considering the choice between a caesarean or vaginal delivery with your doctor
- bottle feeding your baby, rather than breastfeeding
- your doctor prescribing your baby antiretroviral drugs for up to 4 weeks after they have been born
Do not breastfeed your baby if you have HIV, as the virus can be transmitted through breast milk.
Should Pregnant Women Get Tested For Hiv How Is Testing Done
Women who are planning on becoming pregnant or who are pregnant should be tested for HIV as soon as possible. The womans partner should also be tested. The March of Dimes recommends that all women of childbearing age who may have been exposed to HIV should be tested before becoming pregnant. Women who have not been tested before becoming pregnant should be offered counseling and voluntary testing during pregnancy. Women who have not been tested during pregnancy can be screened during labor and delivery with rapid tests which can produce results in less than one hour. This allows for treatment to protect the baby should the results be positive.HIV/AIDS testing is conducted with a blood test.
A womans health care provider may offer testing and counseling or may refer her to a local testing site. Additional information about testing can be obtained from:
- National IV Testing Resources
- CDC-INFO 24 hours/day at 1-800-232-4636
- National Aids Hotline at 1-800-342-AIDS
The Food and Drug Administration has approved the Home Access HIV Test System. This testing system allows for confidential testing with the use of a home testing kit.
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What Are The Signs & Symptoms Of Hiv And Aids
When first infected with HIV, a person may have:
- increased number of infections
- infections that are more severe than is typical
Without treatment, HIV can lead to a very weakened immune system and progress to AIDS. Illnesses that happen in AIDS are called “AIDS-defining conditions.”
AIDS-defining conditions include:
What Is The Treatment For Hiv
Individuals who are HIV positive will likely need to see a specialist. As with many other conditions, early detection offers more options for treatment. Today, there are medical treatments that can slow down the rate at which HIV weakens the immune system. However, there are other treatments that can prevent or cure the conditions associated with HIV. Anti-retroviral drug therapy may be given to a pregnant woman, which has proven to greatly reduce the chance of an infant developing HIV. A cesarean section may be recommended to reduce infant transmission from the birth canal. In the U.S., where other feeding options are available, an infected mother should be discouraged from breastfeeding her infant. Consult your child’s doctor for more information regarding various drug therapies.
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Frequently Asked Questionsexpand All
You and your health care professional will discuss things you can do to reduce the risk of passing HIV to your baby. They include the following:
Take a combination of anti-HIV drugs during your pregnancy as prescribed.
Have your baby by cesarean delivery if lab tests show that your level of HIV is high.
Take anti-HIV drugs during labor and delivery as needed.
Give anti-HIV drugs to your baby after birth.
Do not breastfeed.
Treatment during pregnancy has two goals: 1) to protect your own health, and 2) to help prevent passing HIV to your fetus. Many combinations of drugs are used to manage HIV infection. This is called a “drug regimen.” Anti-HIV drugs decrease the amount of HIV in the body.
Drugs used to treat HIV infection may cause side effects. Common side effects include nausea, diarrhea, headaches, and muscle aches. Less common side effects include anemia, liver damage, and bone problems such as osteoporosis. While unusual, drugs used to treat HIV may affect the development of the fetus. However, not taking medication greatly increases the chances of passing the virus to your fetus.
Your viral load is the amount of HIV that you have in your body.
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How Will My Prenatal Care Be Handled Differently
A multi-care approach is the most effective way for pregnant women with HIV infection to have a healthy pregnancy and delivery. This approach will address the medical, psychological, social and practical challenges of pregnancy with HIV. While the womans pregnancy is being managed by a health care provider and HIV specialist, she may also receive assistance from a social services agency to help her with housing, food, childcare, and parenting concerns.
She would also be receiving counseling support for herself and her partner. Additional care could be provided in the areas of substance abuse and lifestyle counseling. This team effort will provide the best prenatal care plan for women infected with HIV. Many of these services could continue during her postpartum period.
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How Can Vertical Transmission Be Prevented
There is a set of effective strategies that prevent mother-to-child transmission from taking place. These are called PMTCT: prevention of mother-to-child transmission.
Many women living with HIV have given birth to HIV negative children by taking these precautions:
By doing these things, the chances of the baby having HIV become very low under 1%. If you’re on HIV treatment and have an undetectable viral load, the chances are lower still: 0.1%.
Home Delivery And Mtct Of Hiv
Five studies, 2115 mother-baby pairs, were included in this category of meta-analysis . Three of the included studies showed a significant association between home delivery and a higher risk of HIV transmission from mother to the child. Two studies showed no such association . The pooled meta-analysis showed higher odds of MTCT of HIV among HIV positive women who gave birth at home than women who delivered at health facilities in the presence of skilled birth attendants, OR=5.08 . Significant heterogeneity was found. Whereas, the Beggs and Eggers tests showed no statistical evidence of publication bias, p-value=0.142 and p-value=0.055, respectively .
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Heterogeneity And Publication Bias
The heterogeneity of studies was checked using I2 test statistics and its corresponding p-value. A p-value less than 0.05 was used to declare heterogeneity. I2 statistics of 25, 50 and 75% was used to declare low, moderate and high heterogeneity, respectively . Eggers and Beggs tests were used to assess publication bias, and a p-value less than 0.05 were used to declare its statistical significance . The Duval and Tweedie nonparametric trim and fill analysis using the random-effect analysis was conducted for meta-analysis result which showed the presence of publication bias .
Characteristics Of Included Studies
Eight of the studies included in the final analysis were retrospective cohort studies and one study was prospective cohort study . The studies used health facility-based PMTCT data which was collected from 2004 to 2015. All studies included mother-baby pairs who were involved in the PMTCT care in the respective health institutions. Three articles were conducted in Amhara region , two in Oromia region , two in Addis Ababa, capital city of Ethiopia , one study in Southern Nations, Nationality and Peoples Region and one study was conducted in Dire Dawa City administration . The time of infant HIV diagnosis for all of the included studies was at or after six weeks postpartum. The sample size of included studies ranges from a minimum of 71 mother-baby pairs who had a documented HIV test result in Addis Ababa City to 896 in 10 sub-cities in Addis Ababa city . Overall, a total of 3688 mother-baby pairs were included in this review . The quality score of included studies ranges from 6 to 9, with a mean quality score±SD of 8±0.71.
Table 1 Summary characteristics of studies included in the meta-analysis of the prevalence of mother to child transmission of HIV in Ethiopia
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How Is Hiv Transmitted To A Baby
Transmission is the word for when HIV passes from one person to another.
Mother to baby transmission is also known as vertical transmission.
Most vertical transmissions happen near the time of or during labour and delivery . Vertical transmission also includes transmission through breastfeeding.
The biggest risk factor for vertical transmission is the mothers viral load. This is a measure of how much HIV is in your blood.
The main aim of ART is to get viral load to undetectable. This is the same for everyone with HIV. Viral load tests results are in copies per millilitre . Undetectable viral load is when this gets to less than 50 copies/mL.
When we talk about an undetectable viral load in this guide we mean less than 50. If a mothers viral load is undetectable when her baby is born particularly if this has been the case throughout pregnancy the risk of vertical transmission is almost zero.
Undetectable viral load is particularly important at the time of delivery. Most risk factors for transmission are removed by reducing the amount of HIV in the blood to undetectable.
Practically all risk factors point to one thing: looking after mothers health.
Some key points to remember:
- A mothers health directly relates to the HIV status of the baby.
- Having an HIV positive father will not affect whether the baby is born HIV positive.
- The HIV status of your new baby does not relate to the status of your other children.
Transmission Of Hiv From Mother To Child Through Breast Milk
Mother-to-child transmission of HIV is the primary way that children become infected with HIV. Such transmission can take place when the child is still in the mothers womb, around the time of birth, or through breastfeeding after birth. Hundreds of thousands of children are infected this way every year, with most of them in developing countries. Major progress has been made in preventing MTCT when the baby is still in the mothers womb, or around the time the baby is born. In many resource-rich settings, mothers with HIV infection are counseled not to breastfeed their children, and there are feasible and affordable alternatives to breastfeeding. However, in parts of the world where the vast majority of mothers with HIV infection live, complete avoidance of breastfeeding is often not feasible . Therefore, interventions to prevent transmission of HIV infection through breast milk are urgently needed. The authors found that, in addition to complete avoidance of breastfeeding if safe and affordable, exclusive breastfeeding for the first few months of life helps prevent transmission . Another intervention, giving the baby an anti-HIV medicine while breastfeeding, decreases the risk of transmission of HIV from mother to child. Implementation of such interventions, as well as developing more and better interventions, is essential.
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Diagnosing And Treating Hiv In Children
HIV infection can be diagnosed in most infants by 1 month of age, and in all infants by 6 months using special viral diagnostic tests. These tests look for the HIV virus produced by the body instead of antibodies to the virus most adults are diagnosed using an antibody test. Because newborns have some of their mothers antibodies to HIV in their blood for a time, the special tests need to be used.
Infants and children living with HIV can be treated using HIV antiretroviral drugs. While these drugs will not cure HIV, they will slow down HIV and prolong a persons life. Children living with HIV should see their doctor regularly to make sure they are receiving the proper medications and vaccines against other diseases.
Ways Hiv Cannot Be Spread
HIV is not spread by:
- Air or water
- Mosquitoes, ticks or other insects
- Saliva, tears, or sweat that is not mixed with the blood of a person with HIV
- Shaking hands hugging sharing toilets sharing dishes, silverware, or drinking glasses or engaging in closed-mouth or social kissing with a person with HIV
- Drinking fountains
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Ways Hiv Can Be Transmitted
How is HIV passed from one person to another?
Most people who get HIV get it through anal or vaginal sex, or sharing needles, syringes, or other drug injection equipment . But there are powerful tools that can help prevent HIV transmission.
Can I get HIV from anal sex?
You can get HIV if you have anal sex with someone who has HIV without using protection .
- Anal sex is the riskiest type of sex for getting or transmitting HIV.
- Being the receptive partner is riskier for getting HIV than being the insertive partner .
- The bottoms risk of getting HIV is very high because the rectums lining is thin and may allow HIV to enter the body during anal sex.
- The top is also at risk because HIV can enter the body through the opening at the tip of the penis , the foreskin if the penis isnt circumcised, or small cuts, scratches, or open sores anywhere on the penis.
Can I get HIV from vaginal sex?
You can get HIV if you have vaginal sex with someone who has HIV without using protection .
Can HIV be transmitted from a mother to her baby?
HIV can be transmitted from a mother to her baby during pregnancy, birth, or breastfeeding. However, it is less common because of advances in HIV prevention and treatment.
Can I get HIV from sharing needles, syringes, or other drug injection equipment?
You are at high risk for getting HIV if you with someone who has HIV. Never share needles or other equipment to inject drugs, hormones, steroids, or silicone.