Testing is the first and most critical step in reducing mother-to-child transmission. Knowing her status, an expectant mother can receive the essential treatment that will protect her health and the health of her baby.
Prenatal treatment for HIV-positive expectant mothers can protect their babies from HIV by drastically reducing the risk of mother-to-child transmission. Antiretroviral therapy and education services have been proven to significantly reduce the risk of transmission to their infants.
Safe childbirth is an important consideration for any expectant mother, yet many women lack access to proper facilities. We're working to ensure that more women have access to prenatal care and to the adequate health care facilities they need to have a safe place for their delivery.
Child Health Visits are critical in the first few months of a newborn's life. We help provide access to comprehensive routine checkups that can help identify infections and put an HIV-positive child on the path to treatment and stronger health.
Safe Breastfeeding can greatly reduce the risk of HIV transmission from mothers to children through breast milk. Exclusive breastfeeding and antiretroviral (ARV) medicines has protected infants from infection.
Early Infant Testing can measure a child's HIV status in the first few months of life. As a result, HIV-positive children can have early access to the treatment they need to support their long-term healthy survival.
Care and Treatment if a Child is HIV+ is incredibly important. Without treatment, the statistics are bleak — half of HIV infected infants won't make it to their second birthday. Those receiving treatment however, can thrive and remain healthy well into adulthood.
Testing is a key component of HIV prevention, and testing pregnant women is one of the most effective ways to reduce mother-to-child transmission of HIV. If a woman finds out she is HIV-positive, she can begin treatment that can reduce the risk of passing HIV to her baby to less than two percent.
The Foundation works to ensure that more pregnant women promptly receive the treatments they need by improving the availability of HIV testing and counseling during pregnancy, as well as CD4 testing to determine treatment eligibility and assess women’s overall health status.
High-quality treatment and prevention regimens for pregnant women living with HIV drastically reduce the risk of mother-to-child transmission. In accordance with the World Health Organization’s 2010 recommendations for antiretroviral therapy (ART) for HIV-positive individuals, the Foundation supports:
The Foundation strives to ensure that pregnant women have access to a full package of services, including prenatal care, HIV prevention counseling, screening and treatment for sexually-transmitted infections, family planning, nutrition support, and malaria prevention. Health worker training and infrastructure improvements are also part of the Foundation’s work to improve the quality of prenatal care and to encourage clients to continue accessing services.
The Foundation also promotes healthy pregnancies and safe deliveries by working to increase the number of women who delivery in a health care facility. This includes:
Routine health care should be provided for all children. Such care should include assessment of child growth, nutrition, development and mental health; immunizations; evaluation and management of illnesses; guidance for the prevention of injury and disease; dental referrals; and screening for hearing and vision.
In addition to routine care, HIV-positive infants and children, and children born to undiagnosed HIV-positive mothers, require additional assessments and treatment for health support. HIV is a chronic disease that requires regular and careful monitoring. Families affected by HIV need ongoing counseling, support, and referrals for health and community services to meet ever-changing health needs.
Mothers also require critical routine health support following childbirth and throughout their lives. Follow-up care for mothers should include postpartum care, infant feeding counseling, and family planning counseling, along with many other general health topics. As Teleza in Malawi says, “To be HIV-positive is not the end of a life. All you have to do is get educated, follow the rules, and take care of yourself. That way, you can take care of your family.”
In resource-limited settings, an infant who is fed with formula or with breast milk substitutes often faces greater health risks than an infant who is exclusively breastfed, even if the child's mother is HIV-positive.
Breastfeeding, especially early and exclusive breastfeeding, is one of the most valuable interventions for improving child survival. Exclusive breastfeeding for the first six months of life and continued breastfeeding for up to 18 months is the single most effective preventive child survival intervention. The dilemma has been to balance the risk of infants acquiring HIV through breastfeeding with the risk of death from causes other than HIV, in particular malnutrition, diarrhea and pneumonia among non-breastfed infants.
The Foundation aims to prevent mother-to-child transmission of HIV caused by breastfeeding and to promote the healthy, HIV-free survival of all children born to HIV-positive mothers. Providing ARVs to a mother or child during breastfeeding can help reduce the risk of mother-to-child transmission of HIV. Continued counseling and education along with community support are critical for both mothers and infants throughout their lives.
The responsibility of preventing mother-to-child transmission of HIV during pregnancy and childbirth does not end when an infant is born. To achieve the Foundation's mission of eliminating pediatric AIDS, all of our programs must strive to ensure that infants who are uninfected at birth remain uninfected, and that infants with HIV survive and grow into healthy children. Promoting and supporting optimal infant and young child feeding (IYCF) practices is necessary to achieve this goal.
Accurately diagnosing HIV in infants and children is a major challenge. Children who are infected with the virus - before birth, at birth, or during breastfeeding - may not initially exhibit any symptoms of HIV infection or AIDS.
HIV can be diagnosed in adults by testing blood for antibodies to HIV. In children, however, an antibody test is not effective, because a mother's maternal antibodies are passed to her child as a natural means of protection while the infant is developing its own immune system. As a result, antibody tests for infants may yield false positive results for up to 18 months.
Without diagnosis and treatment, 50 percent of HIV-infected infants will die before their second birthdays. But if a baby receives prophylactic antibiotics soon after birth and antiretroviral therapy (ART) as soon as is medically indicated, he/she has a good chance of surviving childhood and living a long, healthy life.
The test used to diagnose babies born to HIV-positive mothers in developed countries, Polymerase Chain Reaction (PCR), tests directly for HIV DNA rather than the HIV antibody. It requires sophisticated, expensive equipment not available in rural settings. Traditionally, the test requires a liquid blood sample, which if taken in a rural area and transported to a testing facility, needs to be kept refrigerated.
However, a new technology has emerged that allows PCR to be performed on small spots of dried blood. The Dried Blood Spots (DBS) are easy to prepare in a resource-limited setting and can be stored and shipped to testing facilities without refrigeration.
The introduction of early infant diagnosis innovations is an important step in the fight against pediatric HIV/AIDS. By identifying infants who need services as early as possible, these children will have a better chance of maturing into healthy adults.
There is no cure for HIV infection. However, early infant diagnosis is critical in helping HIV-positive children lead longer, healthier lives through antiretroviral therapy (ART). Taken every day, these medicines can drastically reduce the amount of HIV in the bloodstream and allow the body to fight off other infections, thereby dramatically slowing the progression of the virus. Sadly, most children still do not have access to these lifesaving medications.
In addition to ART, a number of other proven interventions support the health and well being of children living with and affected by HIV. These include a range of age-appropriate interventions that cater to children's specific needs, such as counseling and peer support activities, appropriate infant and young child feeding practices, care and prevention of opportunistic infections, and educational assistance.