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1. Prevention of mother to child transmission ( pmtct )

2. pmtct Is a programme aimed at reducing and preventing the spread of HIV by treatment of pregnant women and giving prophylaxis to babies. Also seeks to promote: -early attendance of pregnant women to antenatal clinics -early arrival at labour and delivery facilities -testing of pregnant women and their partners -testing of babies -family planning

3. Hiv transmission to child During pregnancy During labour and delivery During breastfeeding

4. Time of transmission Out of 100 babies born to HIV –positive women: 10 likely may acquire HIV during pregnancy 10-20 babies may become infected during labour and delivery 10-20 babies may become infected while breastfeeding

5. Global “The four-pronged global PMTCT strategy” Targeting women of childbearing age Targeting HIV+ women, preventing unwanted pregnancies Targeting HIV+ women that are pregnant Care and support for women, infants & family

6. Goal of preventing transmission through ARVs Prevent disease progression in the mother Prevent transmission of HIV to the infant

7. What ARV drugs do in pregnancy? Reduces the amount of HIV in the mothers’ blood & genital fluids during pregnancy, labour & delivery When given after delivery has already occurred, (PEP) to prevent infection by virus particles

8. The arv drugs used in prenacy .TLD (Dolutegravir/Lamivudine/Tenofovir) . Atripla (Efavirenz/Emtricitabine/Tenofovir)

9. Disadvantages of breastfeeding Risk Transmission of HIV

10. Factors that increase transmission of hiv through breastfeeding Seroconversion (mother acquiring initial infection) during lactation Bleeding or cracked nipples Sub-clinical and clinical mastitis Breast abscesses Mixed feeding Candidiasis (thrush) or ulcers in infants mouth

11. ARVS for the Exposed Infants 1. A single dose of NVP of 2mgs/kg at birth. (In cases when the exposed infant does not receive single dose NVP at birth for e.g. as home delivery, same should be given within 72 hours and covered with an AZT tail as per point 2 below). 2. Oral AZT of 4mgs/kg twice daily for 6 weeks.

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