You should encourage all pregnant women to consent to be tested for HIV. You may be able to do the test yourself (see Section 16.5.1 below), but if you cannot carry out the test, it is available at all health centres and hospitals. Explain to every pregnant woman that if her HIV test result is positive, she can receive effective services to prevent her baby from getting HIV before or after birth. Tell her also that there is treatment for herself and her partner (if her partner is tested and found to be positive for HIV). The core PMTCT interventions are listed in Box 16.2.
Prophylaxis (pronounced 'proff-ill-axis') means 'treatment aimed at prevention'. ARP drugs are given to prevent HIV from being transmitted from an HIV-infected mother to her baby.
Box 16.2 Core PMTCT interventions
- HIV testing and counselling. You will learn more about this later in this study session. (You learned about general counselling principles in Study Session 15.)
- Giving antiretroviral drugs (ARVs) to HIV-positive pregnant women. These drugs act against viruses such as HIV which belong to a virus 'family' called retroviruses. They are given either as part of antiretroviral therapy (ART) for women who are eligible to start treatment for their own HIV infection, or as antiretroviral prophylaxis (ARP) to pregnant women who are not eligible to start antiretroviral treatment at this time. Giving pregnant women ARV drugs either before or during pregnancy benefits them directly, but it also helps to prevent HIV transmission to the baby. According to the 2007 National PMTCT of HIV Guidelines for Ethiopia, ARP should be started at 28 weeks of gestation, but ART can be started at any time provided that the woman is eligible. (You will learn in detail about eligibility criteria for ART in the Communicable Diseases Module).
- Safe delivery practices. These are taught in the Module on Labour and Delivery Care.
- Safe baby feeding practices. You will learn about these in the Module on Integrated Management of Newborn and Childhood Illness.