HIV and Mother to Child Transmission

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In the past mother-to-child transmission of HIV was the cause of death for nearly all of the children that had been diagnosed with the virus before the age of 13. This paper will discuss the causes of mother to child transmission and preventative measures in place to reduce the risk for children with mothers that are HIV positive. Mothers living in third world countries will likely have a much greater risk of transmission because they simply do not have access to the necessary medicines or have knowledge about the virus.

HIV can be transmitted before birth by the fetus coming in contact with infected blood, during birth by coming in contact with tears in the uterine walls that have exposed blood and after birth by being breastfed infected milk. Some of the preventative measures a mother can take to reduce the risk of her child being transmitted the virus are to receive a onetime shot of antiretroviral medicine, have a caesarean delivery and to feed the child formula instead of breastfeeding. Background Mother-to-child transmission (MTCT) of HIV-1 infection is the major source of HIV infection in infants and young children younger than 5 years.

Rollins discusses how “surveillance programs for prevention of mother-to-child transmission of HIV fail to quantify numbers of infant HIV infections averted, often because of poor postnatal follow-up” in his article, Surveillance of mother-to-child transmission prevention programs at immunization clinics: the case for universal screening, (2007). HIV transmission from mother to child during pregnancy, labor and delivery, or breastfeeding is known as perinatal transmission and is the most common route of HIV infection in children (CDC, 2012).

In the absence of HIV prevention measures, the rates of MTCT of HIV-1 have been estimated to range from 25% to 48% in breastfeeding populations in resource-poor settings (Kilewo, 2009). Breastfeeding is the most common mode of transmission among the mother to child was to transmit the virus because of the frequency that the child will come in contact with the infected milk. According to Kilewo in his article, Prevention of Mother-to-Child Transmission of HIV-1Through Breastfeeding by Treating Mothers With Triple Antiretroviral Therapy in Dar es Salaam, Tanzania: The Mitra Plus Study, “resource-rich countries, that se highly active antiretroviral treatment together with elective cesarean section and avoidance of breastfeeding have reduced the rate of MTCT of HIV to below 2% (2009). ” In the United States in 2010, an estimated 217 children younger than the age of 13 years were diagnosed with HIV in the 46 states with long-term, confidential name-based HIV infection reporting since at least 2007; 162 (75%) of those children were perinatally infected (CDC,2012). Read JS, states that “Mother-to-child transmission (MTCT) of HIV is the primary way that children become infected with HIV.

More than 2000 children worldwide are infected in this way every day (2005). ” Problem Statement Due to the fact that mother to child transmission of HIV being the major source of preinatal transmission, it is important to have preventative treatment accessible to vast populations across first world and third world countries. With the use of antiretroviral medicine, caesarean deliveries, and knowledge of risks that breastfeeding carries, the preinatal transmission of HIV to children can be greatly reduced. Preventative Measures

The best way to help reduce the spread of HIV today, is to educate the world about how the virus is spread and how to reduce the risk of receiving it. Kilewo states that “breastfeeding accounts for about 40% of mother to child transmission of HIV-1 in developing countries (2009). ” Dispite breastfeeding beiIn resource rich countries is it much easier to spread knowledge of the risk of breastfeeding a child when the mother is HIV positive. It is also more common in developed countries for the mother to have access to alternative ways to feed her child such as formula.

In third world or developing countries even if the mother is lucky enough to know not to breastfeed her child, having access to alternative ways of feeding or having the resources necessary to afford the safe alternative isn’t always reliable. Morbidity and mortality in infants due to infectious diseases, fear of stigmatization as a result of not breastfeeding, and lack of economic resources are the main obstacles against raising children without breastfeeding in resource-poor settings (Kilewo, 2009).

In the cases were mother does have to breastfeed so that her child doesn’t starve, the baby can use antiretroviral medicine to reduce its risk of receiving the virus. According to the CDC, “Women with HIV who take antiretroviral medication during pregnancy as recommended can reduce the risk of transmitting HIV to their babies to less than 1% (2012). ” The use of antiretroviral medication prior to child birth lowers the awareness of the virus and allows for a much lower risk of the child being transmitted the virus.

In Palombi’s article, Treatment acceleration program and the experience of the dream program in prevention of mother-to-child transmission of HIV, he states that “the Drug Resource Enhancement against AIDS and Malnutrition (DREAM) program is a large antiretroviral therapy treatment program financed by the Treatment Acceleration Program (TAP) of the World Bank (2007). ” In addition to providing antiretroviral treatment to mothers infected with HIV, one major aspect of the DREAM program is nutritional supplementation and prevention of mother-to-child transmission of HIV.

The DREAM program is in place to assist third world countries that are in high risk areas with the prevention of the virus. Developed countries have the antiretroviral medicine available to the public and clinics know to inform the HIV positive mothers of its positive and negative effects. Horvath states that a “caesarean delivery before labor and before ruptured membranes (’elective’ Caesarean section, or ECS): Performing a caesarean section before labor and before ruptured membranes can prevent MTCT of HIV (2009). Where clinically available, performing caesarean deliveries can reduce the risk of transmitting the virus to the child during birth down to zero. The child will no longer be exposed to any ruptured membranes or infected blood during labor or the birthing process. Conclusion In conclusion, the risk of mother to child transmitting has been greatly reduced over the years with clinics being developed in high risk areas around the world along with different methods and more reliable results becoming prevalent.

If knowledge is continued to spread followed by the medicine and resources necessary to assist HIV positive mothers, then we will continue to see the number of children being diagnosed with HIV reduced around the world. Although HIV is the deadliest virus that has every existed, preventive measures are reducing risks and new medicines are allowing HIV positive members of society to function normally and live normal lives.

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