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Q&A: HIV meds and delivery options

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Dr Bronwyn Moore (gynaecologist) answers:

The WHO (World Health Organisation) updated its recommendations for mother-to-child transmission prevention in 2010. Transmission can occur during pregnancy, labour and delivery and after delivery through breastfeeding.

The interventions offered vary depending on numerous factors, including your treatment regime pre-pregnancy and your CD4 count. If you are on long-term ARV therapy, then NVP in labour is not needed. Your baby should still receive NVP after delivery, for at least six weeks and even longer if breastfeeding.

Breastfeeding is an option, and if you are on long-term ARVs then six weeks of NVP is recommended for baby. A caesarean section does not significantly reduce the risk of transmission further if you are on ARVs as your viral load should be low.

It does reduce the risk in women not on treatment with high viral loads. Make sure that you discuss your delivery options with your healthcare provider- you can ask for a c-section but in many settings, this may not be feasible.

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