Prevention of Mother to child transmission
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Transmission from mother to child is by far the most common source of HIV infection in children, particularly in those regions hardest hit by the epidemic. Other sexually transmitted diseases (STIs) can affect infant health as well.
The United Nations agencies recommend a three-pronged strategy to prevent transmission of HIV to infants.
- Primary prevention of HIV among parents-to-be.
- Prevention of unwanted pregnancy among HIV+ women
- Prevention of HIV transmission from HIV+ women to their infants during delivery and breastfeeding.
The range of interventions that fall under this strategy can greatly reduce the risk of preventing perinatal transmisison. These include reducing the vulnerability of girls and young women, voluntary counselling and testing for women and their partners, provision of anti-retroviral drug regimens around the time of childbirth, and support for bottle-feeding or safer breast-feeding practices. Strategies for implementing these interventions are being developed and improved.
Microbicides could contribute to a comprehensive strategy of preventing perinatal transmission.
For many women today, prevention strategies like abstinence, mutual monogamy, and condoms are unrealistic. Too often, women's social or economic status means they have little or no control over the timing or circumstances in which sexual relations take place. Women often fear their partner's reaction to requests to use a condom.
As a "woman-initiated" method, microbicides would give women a tool they could use even without the cooperation of their partner. With more prevention options available, more women would be able to protect themselves, and fewer women would become infected with HIV.
One day broad spectrum microbicides that also act as a contraceptive could be developed, thus protecting women from unwanted pregenancy and STIs including HIV. Because they are women-initiated, it is likely that more women could use microbicides than are currently able to use male condoms, including HIV positive women who choose to avoid pregnancy. Family planning experience has shown that the more methods that are available to women and couples, the more likely they are to find a method that they can use consistently and comfortably. More methods universally translate into fewer unwanted pregnancies. Contraceptive microbicides could offer an additional option for HIV positive women to avoid unwanted pregnancy.