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close this bookPrevention of HIV Transmission from Mother-to-Child: Planning for programme implementation - Conclusions of the meeting (UNAIDS, 1998, 16 p.)
View the document(introduction...)
View the documentBackground
View the documentTaking interventions to scale
View the documentOptimum context
View the documentKey principles
View the documentUnresolved issues
View the documentThe need for action and support
View the documentCoordination mechanisms

Optimum context

The following parameters describe the optimum context in which to implement effectively the interventions necessary to reduce transmission of HIV from mother to child:

· All women should have knowledge about HIV, and should have access to the information necessary to make appropriate choices about HIV prevention and about sexual and reproductive health and infant feeding in the context of HIV.

· HIV counselling should be available for pregnant women and those contemplating pregnancy. Such counselling should address the needs of pregnant women and women living with HIV, including reproductive health issues such as family planning and safe infant feeding. Active referral and/or networking for follow-up counselling, comprehensive care, and social support should be available for the HIV positive woman and her family.

· Pregnant women, and those contemplating pregnancy, should have access to voluntary HIV testing, to test results with the least possible delay, requiring that appropriate laboratory services be available to process such tests, and to counselling.

· All pregnant women should have access to antenatal, delivery and post-partum care, and to a skilled attendant at birth. For the shorter zidovudine regimen to be effective, at least one antenatal visit with follow up is needed before 36 weeks, and preferably before 34 weeks, of gestation. In order to benefit from this intervention, women who access antenatal services prior to 36 weeks should have access to HIV voluntary counselling and testing. Skilled care during delivery is also needed; the shorter zidovudine regimen also involves administration of zidovudine during labour and delivery.

· There should be follow-up of children at least until 18 months, especially for nutrition and for childhood illnesses.