PMTCT Key Concepts

Key Concept 1 – Keep Moms Healthy

·       The healthier the mom (the less HIV she has in her blood and the higher her CD4 cell count), the less likely it is that the baby will become HIV-infected. The sicker the mother (a lot of virus in the blood and low CD4 cell count), the more likely it is that the baby will become HIV-infected.

·       A healthy mom is able to take care of herself and love and take care of her baby and all of her family. Without healthy moms, we will not have healthy families or communities!

Key Concept 2 – Reduce Risk at Every Stage

The risks of passing HIV from a mother living with HIV to her baby are different at different times during and after the pregnancy.

·       During pregnancy, labor and delivery, about 20 out of 100 babies will get HIV if there are no ARVs and other services offered.

·       During breastfeeding, about 12 out of every 100 babies will get HIV with no services offered (this depends a lot on how and how long the mom breastfeeds).

It is important to reduce the risk of transmission at each of these stages.

Key Concept 3 – All Moms Need ARVs

·       One of the best ways to lower the amount of HIV in the mother’s body, increase her CD4 cell count and make her healthy and less likely to pass HIV to the baby is for her to get the care and treatment she needs to be as healthy as possible, including ART. All pregnant women with HIV need to take ARVs.

·       If a mom has a CD4 cell count below 350, the baby is at high risk of getting HIV. According to the WHO, women with a CD4 cell count of 350 or lower should start ART and stay on ART for their entire lives.

·       If a mom has a CD4 cell count above 350, the baby has a lower risk of getting HIV than if the mom’s CD4 cell count is low. According to new WHO recommendations from 2009, women with a CD4 cell count above 350 should also get ARVs during pregnancy to prevent the baby from acquiring HIV.

Key Concept 4 – All Babies of HIV-Infected Moms Need ARVs and CTX

·       All babies need to take ARVs at the time of birth and for the first few weeks of life, to help prevent them from becoming HIV-infected.

·       The type of ARVs a baby takes, and for how long, depends on: if the mother is on lifelong ART, what ARVs the mother took during pregnancy and in the postpartum period and for how long (if not on lifelong ART).

·       HIV-exposed babies need to take CTX starting at 6 weeks to prevent other infections that may make them very sick or lead to a rapid death. Babies should take CTX until it is certain that they are not HIV-infected.

·       If the baby gets tested and is HIV-infected, the baby will also need lifelong ART (WHO recommends that all HIV-infected babies under age 5 years begin ART).

Source: The Comprehensive Peer Educator Training Curriculum and Implementation Manual, (ICAP).