Objective: Review of the success rate in
controlling mother to baby HIV infection in poor countries.
Method: There are procedures to discourage
transfer of HIV from mother to child. Antiretroviral drugs during
pregnancy and the exercise of caution during labour greatly reduce mother
to child infection. Although the most effective treatment lasts an
extended period, a single dose of antiretroviral can cut the transmission
rate by half. Adopting caesarean section to deliver the baby reduces the
baby’s exposure to its mother’s body fluids. This procedure lowers HIV
transmission risks but is likely to be discouraged if the risk of the
intervention outweighs the benefit to the baby. Mothers with HIV are
advised not to breastfeed whenever safe replacements are available.
Weighing risks against benefits is critical when selecting the best
baby-feeding option, particularly when safe water is not available. Then
breastfeeding may still be preferable. Counselling is therefore of prime
necessity for the HIV positive mother.
What are the obstacles? 1. Antiretroviral drugs are
not widely available in resource-poor countries, caesarean section is
often impracticable, and many women lack the needed alternatives to
breastfeeding. 2. HIV-related stigma discourages prevention of
mother-to-child transmission. Some women are afraid to attend clinics that
distribute antiretroviral drugs, or allow their HIV status to be revealed.
Policy measures to Control Spread: 1. HIV prevention programmes need
strong political leadership.
Leaders must speak out about AIDS and difficult
issues like sex and drugs. 2. Comprehensive mobilisation of national
resources is needed. All sectors of the population should be actively
involved, including employers, religious groups, non-governmental
organisations and sufferers. 3. Stigmatisation and discrimination against
sufferers, and gender inequality, which restricts women in their effort to
protect themselves from infection, must be strongly discouraged.
