The document discusses HIV transmission from mother to child during pregnancy, birth, and breastfeeding, noting that the risk of transmission can be reduced to below 5% with antiretroviral treatment during these periods. It also outlines strategies to promote early testing and treatment adherence in order to decrease maternal HIV transmission rates. Finally, it explores recommendations for nursing care including education, adherence support, and promoting access to affordable treatment options.
The document discusses HIV transmission from mother to child during pregnancy, birth, and breastfeeding, noting that the risk of transmission can be reduced to below 5% with antiretroviral treatment during these periods. It also outlines strategies to promote early testing and treatment adherence in order to decrease maternal HIV transmission rates. Finally, it explores recommendations for nursing care including education, adherence support, and promoting access to affordable treatment options.
The document discusses HIV transmission from mother to child during pregnancy, birth, and breastfeeding, noting that the risk of transmission can be reduced to below 5% with antiretroviral treatment during these periods. It also outlines strategies to promote early testing and treatment adherence in order to decrease maternal HIV transmission rates. Finally, it explores recommendations for nursing care including education, adherence support, and promoting access to affordable treatment options.
The document discusses HIV transmission from mother to child during pregnancy, birth, and breastfeeding, noting that the risk of transmission can be reduced to below 5% with antiretroviral treatment during these periods. It also outlines strategies to promote early testing and treatment adherence in order to decrease maternal HIV transmission rates. Finally, it explores recommendations for nursing care including education, adherence support, and promoting access to affordable treatment options.
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HIV During
Pregnancy Sarah Zerbst 7/1/20 Background: • The human immunodeficiency virus • HIV is found in certain body fluids including (HIV) targets the immune system, blood, semen, vaginal fluids, rectal fluids and breast milk: specifically the CD4 cells, which help • Unprotected vaginal or anal sex– in vary rare the body respond to infection. cases, through oral sex with a person living with • Within he CD4 cells the HIV replicates HIV • Blood transfusions with contaminated blood and in turn damages and destroys the • Sharing needles, syringes, or other injection cell thus rendering them infective equipment, surgical equipment or other sharp • Without treatment, the immune system instruments • From a mother living with HIV to her infant becomes weekend to the point it can no during pregnancy, childbirth and/or breastfeeding longer fight off infection Background Continued • According to the World Health Organization (WHO) HIV/AIDS remains on of the world’s most significant health challenges particularly in low- and low-middle-income counties • 23.3 million people were receiving HIV treatment in 2018, however, globally only 62% of the 37.9 million people living with HIV in 2018 were receiving ART • In 2018, 8 out of 10 pregnant women living with HIV, or 1.1 million women, received antiretrovirals (ARVs) Background Continued • Transmission of HIV from a HIV positive mother to child during pregnancy, labor, delivery or breastfeeding (Mother-to-Child transmission) without any intervention ranges from 15% to 45%, however, the rate can be reduced to below 5% with effective interventions during pregnancy, labor, deliver and breast feeding • HIV testing services were only focused on high-burden areas within a county, mother- to-child transmission rates remained high ranging from 18-23%, resulting in a 25- 69% increase in new pediatric HIV infections and increased future treatment cost for children. • There has been tons of ongoing research about Article the maternal transmission of HIV during Summary pregnancy, birth, and breastfeeding. This article uses many different methods of evaluating the negative outcome, that a child will untimely develop HIV due to exposure throughout the pregnancy, birth, and breastfeeding. However, the conclusion was that early detection and initiating ART significantly decreases the risk of transmission. Article Reflection Why is this important to nursing? • HIV/AIDS affects every walk of life throughout the world, therefore, as a nurse it is my (our) job to not only screen individuals and provide treatment throughout their life span, we must also support them in their times of need, such as becoming pregnant and having a baby. Years ago it was unheard of for a HIV positive mother to have a baby without the risk of giving HIV to her unborn child. Fast forward through better advancements in ART and longevity studies of children born to HIV positive mothers, proper treatment has greatly decreased the instance of of transmission to only about 5% throughout the pregnancy, birth, and/or breastfeeding. Recommendations How can nursing promote the decrease in maternal transmission of HIV
• Early diagnosis is crucial, and is now one of the standard tests
completed during the first OB appointment • Emotional reassurance and education about HIV and transmission of HIV to the fetus • Early initiation of ART and continued verification that ART is working • Routine lab work to monitor ART’s effectives without significant negative effects to both the mother and fetus • Education on the necessity of continued adherence to treatment throughout pregnancy, birth, and breast feeding • Collaborate with social services as ART is extremely expansive, therefore, the nurse would need to provide the patient of ways to decrease the cost • WHO recommends that all mothers living with Can mother’s HIV should receive life-long antiretroviral living with HIV therapy (ART) to support their health and ensure the wellbeing of their infant breastfeed their • In counties that have opted to promote and children in the support breastfeeding together with ART, mothers living with HIV who are on ART and same way as adherent to therapy should breast feed mothers without exclusively for the first 6 months and then add complementary feeding until 12 months of age HIV? • There it is a consensus that the risk of transmitting HIV during breastfeeding is low as long as the mother is adherent to ART Patient Education • Support the patient • Education on disease, treatment, prognosis, complications, etc. • Offer social support groups to aide in coping with the diagnosis • Offer ways to ease the cost of ART • Provide information about free clinicals/pharmacies • Assist with completing any documents to decrease the cost of ART • Educate on the impotence of visiting the health care provider regularly • Educate on the importance of taking all HIV prescribed medication according to the MD’s orders • Educate on the risk of transmission– less than 1% as long as the patient is complaints with HRT • Educate the patient on providing the infant with ART for 4-6 weeks after delivery • Educate the patient that should her HIV-Viral Load increase, a c-section may be required • Educate the patient on breastfeeding Questions? References: • Drake, A. L., Wagner, A., Richardson, B., & John-Stewart, G. (2014). Incident HIV during Pregnancy and Postpartum and Risk of Mother-to-Child HIV Transmission: A Systematic Review and Meta-Analysis. PLoS Medicine, 11(2). https://doi.org/10.1371/journal.pmed.1001608 • Ishikawa, N., Dalal, S., Johnson, C., Hogan, D. R., Shimbo, T., Shaffer, N., … Baggaley, R. (2016). Should HIV testing for all pregnant women continue? Cost-effectiveness of universal antenatal testing compared to focused approaches across high to very low HIV prevalence settings. Journal of the International AIDS Society, 19(1), 21212. https://doi.org/10.7448/ias.19.1.21212 • World Health Organization. (2019). HIV/AIDS. Retrieved: https://www.who.int/news-room/facts-in-pictures/detail/hiv-aids • World Health Organization. (2017). HIV/AIDs. Q&A. Retrieved from: https://www.who.int/news-room/q-a-detail/hiv-aids • World Health Organization. (2016). HIV and infant feeding. Retrieved: https://www.who.int/news-room/q-a-detail/hiv-aids • World Health Organization. (2020). Mother-to-child transmission of HIV. Retreived: https://www.who.int/hiv/topics/mtct/about/en/
