Session 17 Hiv Overview
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Overview
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Adapted from: WHO IYCF Counseling :An Integrated Course
17/1
Overview of HIV and infant feeding After completing this session participants will be able to: • explain the risk of mother-to-child transmission of HIV • describe factors which influence mother-to-child transmission • outline approaches that can prevent mother-to-child transmission through safer infant feeding practices • state infant feeding recommendations for women who are HIV-positive and for women who are HIV-negative or do not know their status
17/2
Defining HIV and AIDS HIV • Human immunodeficiency virus is the virus that causes AIDS
AIDS • Acquired immunodeficiency syndrome is the active pathological condition that follows the earlier, non-symptomatic state of being HIV-positive
17/3
Mother-to-child transmission of HIV Young children who get HIV are usually infected through their mother • during pregnancy across the placenta • at the time of labour and birth through blood and secretions • through breastfeeding
This is called mother-to-child transmission of HIV or MTCT
17/4
Estimated risk and timing of mother-tochild transmission of HIV in the absence of interventions Timing of MTCT of HIV • During pregnancy • During labour and delivery • During breastfeeding
Transmission Rate 5-10% 10-15% 5-20%
_______________________________________________________________________________________________________
• Overall without breastfeeding 15-25% • Overall with breastfeeding to 6 months 20-35% • Overall with breastfeeding to 18–24 months 30-45%
17/5
100 mothers and babies
100 mothers and babies
Assume prevalence of HIV infection among women is 20 % Q. How many of these women are likely to be HIV-positive ?
17/6
100 mothers and babies ++
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17/7
100 mothers and babies ++
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17/8
100 mothers and babies ++
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17/9
100 mothers and babies
17/10
20 babies
17/11
20 babies
17/12
20 babies
17/13
Factors which affect mother-to-child transmission of HIV • • • • • • • •
Recent infection with HIV Severity of disease Sexually transmitted infections Obstetric procedures Duration of breastfeeding Exclusive breastfeeding or mixed feeding Condition of the breasts Condition of the baby’s mouth
17/14
Policy of supporting breastfeeding “As a general principle, in all populations, irrespective of HIV infection rates, breastfeeding should continue to be protected, promoted and supported.”
HIV and Infant Feeding: a policy statement, developed collaboratively by UNAIDS, WHO and UNICEF, 1997.
17/15
Infant feeding recommendations for HIV-positive women • When replacement feeding is acceptable, feasible, affordable, sustainable and safe, avoidance of all breastfeeding by HIVinfected mothers is recommended • Otherwise, exclusive breastfeeding is recommended during the first months of life
17/5
1000 mothers and babies
17/6
1000 mothers and babies
17/1
Overview of HIV and infant feeding After completing this session participants will be able to: • explain the risk of mother-to-child transmission of HIV • describe factors which influence mother-to-child transmission • outline approaches that can prevent mother-to-child transmission through safer infant feeding practices • state infant feeding recommendations for women who are HIV-positive and for women who are HIV-negative or do not know their status
17/2
Defining HIV and AIDS HIV • Human immunodeficiency virus is the virus that causes AIDS
AIDS • Acquired immunodeficiency syndrome is the active pathological condition that follows the earlier, non-symptomatic state of being HIV-positive
17/3
Mother-to-child transmission of HIV Young children who get HIV are usually infected through their mother • during pregnancy across the placenta • at the time of labour and birth through blood and secretions • through breastfeeding
This is called mother-to-child transmission of HIV or MTCT
17/4
Estimated risk and timing of mother-tochild transmission of HIV in the absence of interventions Timing of MTCT of HIV • During pregnancy • During labour and delivery • During breastfeeding
Transmission Rate 5-10% 10-15% 5-20%
_______________________________________________________________________________________________________
• Overall without breastfeeding 15-25% • Overall with breastfeeding to 6 months 20-35% • Overall with breastfeeding to 18–24 months 30-45%
17/5
100 mothers and babies
100 mothers and babies
Assume prevalence of HIV infection among women is 20 % Q. How many of these women are likely to be HIV-positive ?
17/6
100 mothers and babies ++
+ +
+
+
+
+
++ + +
+
+ +
+ +
+
+ +
17/7
100 mothers and babies ++
+ +
+
+
+
+
++ + +
+
+ +
+ +
+
+ +
17/8
100 mothers and babies ++
+ +
+
+
+
+
++ + +
+
+ +
+ +
+
+ +
17/9
100 mothers and babies
17/10
20 babies
17/11
20 babies
17/12
20 babies
17/13
Factors which affect mother-to-child transmission of HIV • • • • • • • •
Recent infection with HIV Severity of disease Sexually transmitted infections Obstetric procedures Duration of breastfeeding Exclusive breastfeeding or mixed feeding Condition of the breasts Condition of the baby’s mouth
17/14
Policy of supporting breastfeeding “As a general principle, in all populations, irrespective of HIV infection rates, breastfeeding should continue to be protected, promoted and supported.”
HIV and Infant Feeding: a policy statement, developed collaboratively by UNAIDS, WHO and UNICEF, 1997.
17/15
Infant feeding recommendations for HIV-positive women • When replacement feeding is acceptable, feasible, affordable, sustainable and safe, avoidance of all breastfeeding by HIVinfected mothers is recommended • Otherwise, exclusive breastfeeding is recommended during the first months of life
17/5
1000 mothers and babies
17/6
1000 mothers and babies
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