Mother To Child Transmission Of HIV

Mother to child transmission MTCT is the largest source of HIV infection in children below 15 years MTCT also known as perinatal or vertical transmission occurs when HIV is spread from an HIV positive woman to her baby during pregnancy labour and delivery or breast feeding HIV and AIDS is one of the major causes of death in children throughout the world According to Labbok 2003 of 580 000 deaths from HIV and AIDS in children under 15years of age 500 000 have been in Africa 8090% of such deaths are due to MTCT and 200 000 were secondary to breast feeding

Increasing number of children have HIV infection especially in the countries hardest hit by the pandemic In 2002 an estimated 3 2 million children under 15 years of age were living with HIV and AIDS a total of 800 000 were newly infected and 610 000 died HIV and AIDS have been estimated to account for about 8% deaths in children under 5 years of age in Sub Saharan Africa In areas where the prevalence of HIV in pregnant women exceeded 35% the contribution of HIV and AIDS to childhood mortality was as high as 42%

World wide in 2001 1 8 million women became infected with HIV and approximately 800 000 children also became infected the majority of them via MTCT Breast feeding is an important mode of transmission during the postpartum period accounting to nearly one third of entire MTCT of HIV In East Africa it is estimated that 1020% of women are HIV positive2 With the HIV epidemic showing shift towards women and young people the increasing seroprevalence among women will lead to an increase in the MTCT

Of great concern in this HIV era is the issue of breast feeding Besides being an intense personal concern the issue of HIV transmission through breast feeding is also of public health importance especially in countries where both fertility rates and HIV infection rates among pregnant women are high Now it is widely recognized that HIV is transmitted to an infant during breast feeding with an average of approximately one out seven infants born to an HIV infected mother becoming infected through breast feeding up to 24 months Efficiency of HIV transmission through breast milk ranges between 1629% Of the 30% of babies who get infected vertically the relative frequency of timing of transmission is as follows 2% early in gestation 3% late in gestation 15% during labour 5% early in postpartum period and 5% in late postpartum period Although WHO unicef and other United Nations agencies currently recommend that HIVpositive mothers avoid breast feeding if replacement feeding from birth is acceptable feasible affordable sustainable and safe AFASS it is not practically possible to adopt this policy in resource limited countries like Uganda Thus research is necessary to make this feasible

This article summarizes research findings regarding MTCT of HIV particularly through breast feeding

Knowledge on the role of breast feeding in MTCT of HIV

In order that interventions on the prevention of MTCT to become effective it is important to know the level of knowledge attitude and practices of women in relation to MTCT of HIV and breast feeding According to community based crosssectional study done among mothers aged 1640 years in Dar es Salaam only 25% of the population knew that breast feeding could be source of HIV transmission Among women who knew about HIV transmission through breast feeding 54 1% indicated they will avoid breast feeding while 45 9% indicted they will continue breast feeding The main reason given was stigmatization Generally the knowledge and attitudes regarding MTCT and breast feeding in developing countries are not well known Thus there is need to educate the masses on this issue Unlike in developed countries where MTCT of HIV is known to most mothers a lot still ahs to be done in developing countries where the vast majority of women are completely ignorant about it.