BASIC QUESTIONS AND ANSWERS ON MTCT

What does MTCT stand for?

It is the prevention of Mother To Child Transmission of HIV/AIDS from the pregnant woman to her child to be born.

How does this transmission happen?  

Contamination of the foetus occurs during pregnancy and particularly at the end of pregnancy, in the course of delivery and through breast feeding.  

Is this contamination straightforward?

It does not happen automatically and the rate of transmission depends on how severe the mother is contaminated, the term of pregnancy and the type of delivery. It is 25 to 30 percent without any treatment. A good medical care of the mother can bring this contamination down to less than 5 percent, or even totally avoid it.

Which advice should be given to a young woman who wishes to protect her child from HIV/AIDS?  

The contamination of the children to be born is a great injustice and non respect of the rights of the child. Any woman who wishes to have a baby in countries with high rate of HIV prevalence must consent, well before pregnancy, to a number of examinations such as: HIV blood test, the blood group and the electrophoresis of haemoglobin for couples of black race. These tests help to know her health condition and take preventive measures. If a pregnancy has already begun, an HIV test is advised in the first quarter of the pregnancy.  

What should be done in the event of a positive test?  

The doctor trained for medical care of HIV-positive persons will, after much information (counselling), suggest tests as to evaluate the degree of the disease: CD4, viral load and aenemia. The tests are also requested from the partner. According to the level of contamination, the doctor will recommend that anti-retroviruses drugs be taken after the 3rd month of pregnancy for the very sick women. In these cases, women will continue their treatment after childbirth. For women with low level contamination, one advises that drugs be taken until childbirth. In all cases, the baby will take one or two drugs as syrup from the day of birth. Bottle-feeding is strongly recommended.  

Are all HIV-positive women prohibited from breast feeding?  

The HIV virus passes into the mother's milk, and breast feeding increases the risk of contamination for the baby. It is thus advised for women able to pay for bottle-feeding, to use it. Whenever that is not possible, one recommends an exclusive breast-feeding of short duration (6 months) with an instantaneous stop.  

Could an HIV-negative woman with an HIV-positive husband, contaminate her baby?  

The woman must herself be contaminated before transmitting the disease to her baby. This is why the use of condoms is recommended for those couples with opposite HIV status.  

Is the Caesarean an obligation for the HIV positive women?  

The "HIV-positive" status alone, does not force to resort to the caesarean. However, when a caesarean is practised before the beginning of any labor, the womb being intact, the rate of contamination is very low. The caesarean is thus advised in a situation where labor is likely to be difficult and whenever highly contaminated women started taking the drugs late.  

In the event of natural delivery, it is recommended that everything be done so that work does not take too long, that early opening of the womb be avoided and moreover, strict asepsis instructions be respected. The baby will then be washed with disinfectant medical products.

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