HIV and Pregnancy

A hand holding an AIDs ribbon to spread awareness about mother-to-child HIV transmission.

Mother-To-Child HIV Transmission Eliminated in Thailand

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A hand holding an AIDs ribbon to spread awareness about mother-to-child HIV transmission.

WHO’s guidelines have influenced Thailand’s government to curb mother-to-child HIV transmission.

One of the biggest concerns in the world is the spread of HIV. This happens through unprotected sex, sharing needles, and more. Actions like these leave adults at risk. Unfortunately, the spread of HIV doesn’t stop with there. HIV transmission can happen during pregnancy, birth, or breastfeeding as well, causing an unborn child or infant to contract the disease. The World Health Organization (WHO) has made efforts to stop mother-to-child HIV transmission, and it has worked for Thailand.

Mother-To-Child HIV Transmission

Parents and soon to be mothers with HIV need to be aware that pregnancy, birth, and breastfeeding is the most common to spread the disease to your child. The CDC states these three facts:

  • Approximately 8,500 women living with HIV give birth annually.
  • Most (73%) of the estimated 174 children in the United States who were diagnosed with HIV in 2014 got HIV through perinatal transmission.
  • Most (88%) of the estimated 104 children in the United States diagnosed with AIDS in 2014 got HIV through perinatal transmission.

In order to protect your child, it is important to be tested once you discover that you are pregnant. The risk of HIV significantly decreases to around 1 percent if HIV medicines are taken within the first 4-6 weeks.

How Thailand Has Eliminated This Transmission

Around the mid-1990’s, the rate of mother-to-infant HIV transmissions in Thailand was 20-40 percent. Using WHO’s recommended strategy, the government has successfully reduced transmissions to 1.9 percent. This strategy focuses on four areas of prevention and care:

  • The prevention of HIV in women of childbearing age
  • Stopping unintended pregnancies in women living with HIV
  • The prevention of HIV transmission from an HIV-infected woman to her infant
  • Provision of appropriate treatment, care, and support to women and children living with HIV

Thanks to the government’s initiative, they followed this strategy through the promotion of condoms, the distribution of HIV risk materials, and other efforts. Soon, more government money flowed into Thailand’s HIV/AIDS programs because of their successful efforts. Women have since had more access to HIV testing and antiretroviral therapy.

Awareness and determination like this spell a bright future for stopping HIV in its tracks.

Attempts to Decrease Mother-to-Infant Transfer of HIV in Underdeveloped Countries

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HIV prevention ranks high on the priority list, especially among African nations that are seeing the highest rates of transmission. Challenges to implementing ways of preventing the transfer of HIV continue to crop up. One such challenge is in regards to HIV-positive women transferring the virus to their babies. Fortunately, for many communities, access to antiretroviral therapy means a measure of control over the spreading and transferring of HIV. It is in areas that are poor, isolated, and have limited medical resources where women are more likely to pass on the infection to their children.

Nigeria has continued to remain at the top of the list when it comes to death rates from HIV and also in the number of new infections each year. The nation is second only to South Africa for the number of HIV-positive children. To make matters worse, only 20% of those with HIV have access to antiretroviral treatments. Poverty certainly plays a part, and those in rural communities are even more limited in their access to certain types of medical care. One institute decided to implement an idea to help combat this growing problem.

Promoting Education, Screening, and Treatment to Prevent the Transfer of HIV

The idea was to efficiently provide medical testing, treatment, and education to those in rural communities. Women were given a package of services, and their husbands were also encouraged to get involved. Those in the villages who are responsible for providing healthcare were also instructed in how to provide a range of services. These included midwives, as their services are regularly sought after by those in the community. Cultural norms in certain areas include seeking medical attention and advice from individuals other than physicians.

The results of such efforts are promising. There was a decrease of nearly 75% in new infections for areas where this simple and cost-effective plan was put into practice. Results like this give hope that halting the spread of HIV can be achieved, even in regions where resources are limited. Such programs like this may be able to save many lives and have an influence on the transfer of HIV in developing lands.

Low Risk of Birth Defects

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Low Risk of Birth Defects: HIV and Antiretroviral Medication

With new compounds and therapies expanding what can be done for individuals living with HIV, more and more infected women are looking towards pregnancy and childbirth. The combination of pregnancy and the latest antiviral medications is always a cause of concern, as we often don’t have enough data to make a definitive decision on whether a certain medicine should be given to an individual while pregnant. We also need to know when it is most likely for a mother to infect her infant, and which medicines are best at keeping the rate of infection low. Certainly, many antiretroviral drugs developed in the fight against HIV have been thought to increase the potential of birth defects in the unborn children. A new study, however, shows the opposite. Indeed, it confirms a low risk of birth defects by antiretroviral medications used during pregnancy.

This study – the Pediatric HIV/AIDS Cohort Study (PHACS) Surveillance Monitoring of ART Toxicities (SMARTT) study – released its findings on 10 November 2014. Atazanavir was the only antiretroviral drug that was shown to increase the otherwise low risk of birth defects among HIV-positive women. This medication showed a 2-fold increase in the risk of birth defects, particularly musculoskeletal and skin anomalies. However, another study confirmed that at least three varied regimens of anti-HIV medications—that did not include atazanavir—was safe for women who are expecting. In fact, all other antiretroviral, anti-HIV medications tested in these studies showed no increase in the risk of birth defects. This is great news for HIV infected women who still want to become mothers. With the risks of infecting their child minimal, and the side effects almost non-existent, the hopes of researchers are high that we will find ways to altogether eliminate the transfer of HIV between mother and child.

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