What are the three ways of HIV transmission from mother to child?
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HIV can be transmitted from an HIV-positive mother to her child during pregnancy, childbirth, and breastfeeding. The three primary routes of mother-to-child transmission (MTCT) of HIV are:
Intrauterine Transmission: Intrauterine transmission occurs when HIV crosses the placenta and infects the fetus during pregnancy. HIV can be present in maternal blood and can cross the placental barrier, infecting the developing fetus. Intrauterine transmission is responsible for a portion of HIV infections in infants born to HIV-positive mothers, particularly when maternal viral load is high or maternal HIV infection is not adequately controlled with antiretroviral therapy (ART) during pregnancy.
Intrapartum Transmission: Intrapartum transmission, also known as peripartum or during childbirth transmission, occurs when the infant is exposed to HIV-infected maternal blood and genital fluids during the process of labor and delivery. Intrapartum transmission can occur through contact with maternal blood and secretions in the birth canal as the infant passes through during delivery. Factors such as prolonged labor, rupture of membranes, and maternal viral load at the time of delivery can influence the risk of intrapartum transmission.
Postpartum Transmission through Breastfeeding: Postpartum transmission occurs when HIV is transmitted to the infant through breastfeeding. HIV can be present in breast milk, and infants who are breastfed by HIV-positive mothers are at risk of acquiring the virus through ingestion of contaminated breast milk. Postpartum transmission through breastfeeding is a significant route of HIV transmission in settings where breastfeeding is common and safe alternatives to breastfeeding are not readily available. The risk of postpartum transmission through breastfeeding can be reduced with antiretroviral therapy (ART) for both the mother and the infant, as well as through strategies such as exclusive breastfeeding or formula feeding, depending on the local context and guidelines.
Preventing mother-to-child transmission of HIV (PMTCT) requires comprehensive strategies that address all three routes of transmission through a combination of antiretroviral therapy (ART) for the mother and infant, safe delivery practices, and infant feeding options to reduce the risk of HIV transmission during pregnancy, childbirth, and breastfeeding.