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Introduction

 

Give life to the yet to be born child: Prevent mother to child transmission of HIV

Prakash Hebbar

“What? Can an unborn child contract HIV?” exclaims the 20 year old village girl with disbelief and  fear.. She is shaken to the core when she comes to know that her child is HIV positive.

Clearly, awareness about HIV/AIDS has not yet reached rural areas.. Chances are that if a doctor advises a pregnant woman to undergo a HIV test, she never comes back to him for consultation. The stigma attached to even talking about HIV is the reason for the apathy.

Many a time the mother comes to know about her own HIV status when her child tests positive. If a mother contracts HIV either before or during her pregnancy, there is a possibility of transmission of HIV to the child. .As long as there is no direct contact with maternal blood, the child is safe.  However, HIV can be transmitted to the child through the placenta during her pregnancy, through the process of vaginal childbirth or through breast milk.

Chances of infection through the placenta are a mere 7 percent, Chances of transmission from mother to child during first twenty-four hours of childbirth are 15 percent and during breastfeeding 15 percent. After 24 months, it is risky for mothers living with HIV/AIDS to breastfeed their children.

But these statistics are not entirely reliable. They are based on an estimate, because the number of pregnant women who get the HIV testing done is almost negligible as these tests are not mandatory.

Dr. Asha Benakappa, a child specialist, says that a child should not be deprived of the benefits of essential nutrients present in breast milk. Chances of a child contracting HIV are very slim when it is on exclusive breast-feeding regime. But, if a child is on a mixed feeding regime - breast milk as well as cow’s milk – it is susceptible to HIV infection.

Care must be taken while feeding the child as there are chances of infected blood getting entry into the child’s body via a bleeding nipple can not be ruled out.  As the HIV virus is extremely sensitive, even a slight increase in the temperature destroys the virus.  A safer option is to collect the breast milk in a tumbler or cup and keep it in a bowl of hot water and feed the child with the lukewarm milk.

HIV positive women face several problems while undergoing tests such as making arrangements for the expenses and hiding their status from others. The government has initiated several PPTCT (Prevention of Parent to Child Transmission) centers in almost all district and taluk level government hospitals to help women address these issues.  Free counseling, testing and treatment and confidentiality are available in these centers. With proper care and treatment, it is possible for an infected mother to have an HIV free baby.

Children can also get infected with the AIDS virus when they are older.  “Street children, child laborers, children of sex workers, children pushed into sex work, victims of sexual abuse, children who indulge in sex work on their own come under the high risk groups, which have risks of contracting HIV/AIDS,” says Lalita  Handa, of Clinton Foundation.

The ART therapy, which can keep opportunistic infections at bay and prevent the child from reaching the AIDS stage, is available.

But people need to come forward to avail all the facilities offered. In the Balgot district of Karnataka, where the number of people with HIV is very high, most people come out in the open and declare their HIV status without feeling threatened. They have overcome the stigma and discrimination associated with HIV to a large extent – an example many others need to emulate.

 

 
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