Prevention of Mother to Child Transmission of HIV (PMTCT)

Globally, there are approximately 1.4 million pregnant women living with HIV in low and middle-income countries. Without intervention approximately 25-45% of infants born to HIV positive mothers will become infected. Transmission occurs during pregnancy, labor, and delivery and during breastfeeding and the risk increases with the duration of breastfeeding. Antiretroviral therapy given to expecting mothers works to reduce the risk of transmitting HIV from an HIV positive mother to her unborn child. In the United States transmission has been reduced to

The AMPATH Prevention of Mother to Child Transmission (PMTCT) program is one of the most successful HIV control programs world-wide. AMPATH launched its comprehensive PMTCT program in 2005. We currently support PMTCT services across 100 sites in western Kenya. On a monthly basis we provide HIV testing for 99% of all mothers who attend antenatal care clinics in our catchment area (approximately 3000 expectant mothers each month). Women who are diagnosed with HIV are referred to one of AMPATH's comprehensive HIV treatment clinics. Over 90% of women are successfully referred. AMPATH provides HAART from 14 weeks gestation and continues through weaning in order to minimize the risk of mother-to-child transmission. For women with advanced HIV disease we continue patients on HAART for the rest of their life. All of our expectant mothers are offered infant feeding counseling, and food supplementation throughout pregnancy in order to ensure the very best neonatal outcomes possible. Free formula supplementation is provided for women who are too sick to breast feed or infants who are very sick.

In 2009 we treated 6647 women with antiretroviral prophylaxis. 2615 women were continued on treatment for life. The HIV transmission rate at 6 weeks of life among women who received ≥2 weeks of HAART was 2.5% - similar to rates of transmission in the USA. The 18-month HIV transmission rate among women who received ≥2 weeks of HAART was 3.6%. With additional funding and support we will strive to achieve less than 1% transmission 2012.