How do you prevent mother-to-child transmission of HIV?

From online petitions to angry baby protests, it’s hard to miss ONE’s focus on the Global Fund and our goal to ensure that virtually no child is born with HIV by 2015. But throughout this campaign, many of you have rightfully asked, “How does this exactly work?”

It’s a miracle of modern medical technology that we’re able to prevent the mother-to-child transmission of HIV (PMTCT). To help you understand, we’ve created a CliffsNotes version of how it works:

An HIV-positive mother can pass HIV on to her baby any time during pregnancy, labor, delivery and breastfeeding, so the transmission of the virus must be blocked at each stage. The 2010 World Health Organization guidelines recommend that HIV-positive pregnant mothers should go on a regimen of three antiretroviral drugs (ARVs) as soon as possible — and stay on these drugs until their infant is born and breastfeeding has concluded.

As soon as the infant is born, the baby should take nevirapine — a very inexpensive drug — daily for six weeks. The infant should be formula-fed rather than breastfed if possible, but it’s recognized that formula feeding is both expensive and difficult to do safely in resource-limited settings, so the mother is recommended to breastfeed her child exclusively for six months while continuing to take ARVs. In a recent study conducted by Harvard University in Botswana, mothers who adhered to this regimen reduced transmission of HIV to their babies by an amazing 99 percent.

These prevention guidelines have evolved over the years as scientists have learned more about how to most effectively reduce the risk of transmission while also working to minimize drug resistance for our most effective treatment tools. Many policymakers stress that access to effective contraception to prevent unintended pregnancies is also important for women who are HIV-positive.

For more details on the PMTCT process, including a chart that maps which drugs are used when and in what settings, visit AVERT’s handy guide. Also, be sure to check out WHO’s global strategic vision for 2015.


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