FAQ – Prevention of Parent to Child Transmission (PPTCT)

Q.1 What is the government’s stand on breast feeding in case of HIV positive mothers?
Ans: Best practice as recommended by UNICEF and supported by NACO is followed. Messages will be consistent with the related programme of RCH. Every effort should be made to promote exclusive breast feeding for upto four months in the case of HIV positive mothers followed by weaning, and complete stoppage of breast feeding at six months in order to restrict transmission through breast feeding. However, such mothers will be informed about the risk of transmission of HIV through breast milk and its consequences, and would be helped for making informed choice regarding infant feeding.

Q.2. Could an STD affect the foetus in a pregnant women?
Ans: Yes ,STD can affect the foetus in the womb or during delivery causing infection of the foetus, birth defect or even death of the child.

Q.3 Can a baby have the HIV test?
Ans: Yes, but it will not necessarily show whether the baby is infected. This is because the test is for HIV antibodies and all babies born to mothers with HIV are born with HIV antibodies. Babies who are not infected lose their antibodies by the time they are about 18 months old. However most babies can be diagnosed as either infected or uninfected by the time they are three months old by using a different test, called a PCR test. The PCR test is more sensitive than the HIV test, and is not used in the standard HIV testing of adults. It looks for the presence of HIV itself, not antibodies.

Q.4 What are the possible advantages?
Ans: If a pregnant woman has a positive test result there are now drugs that can reduce the risk of her passing HIV on to her baby in the womb or at birth. Delivery by elective Caesarean Section also reduces the risk of a baby becoming infected. It is usually best for babies to be breast-fed. However, if a mother has HIV, beast-feeding will increase the risk of her baby becoming infected. If a pregnant woman has a negative test result this can be very reassuring.

Q.5 What are the possible disadvantages?
Ans: Some pregnant women feel that they could not cope with finding out that they have HIV and that they may have put their baby at risk. A woman who is infected with HIV can still become pregnant and have a baby. Being pregnant will not increase her chances of developing AIDS. But some doctors think that pregnancy will make a woman who already has AIDS more seriously ill. If a woman’s partner is not infected with HIV he is at risk of becoming infected if they have sexual intercourse without a condom. An HIV positive woman also has to consider how she will cope if her baby is infected with HIV. Some doctors think that a woman who has recently been infected, or a woman who has AIDS, is more likely to have an infected baby.

Q6. How does a mother transmit HIV to her unborn child?
Ans: An HIV-infected mother can infect the child in her womb through her blood. The baby is more at risk if the mother has been recently infected or is in a later stage of AIDS. Transmission can also occur at the time of birth when the baby is exposed to the mother’s blood and to some extent transmission can occur through breast milk..

Q7. Are all pregnant women tested?
Ans: Pregnant women are not automatically tested for HIV. In some ante-natal clinics the test is offered and in others women have to ask for it. All pregnant women can have an HIV test. A woman will never be tested without her consent. If a woman is not sure what the arrangements are at her ante-natal clinic, she can ask her doctor or midwife about an HIV test.

Q8. What happens when you have the test?
Ans: Before taking an HIV test a woman should be offered the opportunity to talk to someone about the test and what the result will mean. Then the woman can make up her mind whether she wants to be tested or not. If a woman has a test, the clinic will tell her when she can come and get the result. This might be a few days or a week. The HIV test involves taking a small amount of blood, usually from a person’s arm. If you are pregnant when you have the test you will probably not need to give extra blood, as it should be possible for the test to be done at the same time as other blood tests. The test can be done at any time. But it takes about three months after being infected for a person’s blood to have enough antibodies in it for them to show up in the test. For this reason most people are advised to wait at least for three months after their last risk of being infected before they have a test. When a woman is given the result of her HIV test she should be given the opportunity to talk to someone about it. This is important whether the result says a woman is infected or not.

Q9. What happens if a woman has a positive test result?
Ans: When a woman has a positive test result she should be able to plan with a doctor or midwife what happens next and arrange to have follow-up checks. She will be offered special medical care to reduce the risk of her baby being infected. Some pregnant women with HIV decide to have their baby. Others choose to have a termination. The decision to terminate a pregnancy is very personal and difficult. Someone who has a termination needs time to grieve for the loss of their baby. Someone who is HIV positive also needs to think about how it will affect decisions about pregnancy in the future.