By Francesca Hangeior.
Now, pregnant women living with the Human Immunodeficiency Virus who are on Antiretroviral Therapy and have a low or undetectable viral load can have a vaginal delivery, says the National Agency for the Control of AIDS.
In as much as HIV can pass to the infant during birth, NACA said the risk of transmission is low in women with virally suppressed loads.
The agency noted that the advances in HIV treatment have greatly lowered the chances that a birthing parent would pass HIV on to their baby (also known as perinatal HIV transmission, vertical transmission, and sometimes called ‘mother-to-child’ transmission).
According to NACA, Nigeria has the highest burden of children born with HIV in the world.
It, however, warned that HIV can be transmitted from an infected mother to her child during pregnancy, childbirth, and breastfeeding if she is not on treatment.
The Deputy Director, Community Prevention and Care Department, NACA, Dr Yewande Olaifa, said for many years now, pregnant women living with HIV have been giving birth vaginally and not only through caesarean sections.
Olaifa said, “Yes, for over a decade now, vaginally, women can deliver unless it is contraindicated because of obstetrics matters.
“But as long as there is no contraindication, she can deliver per vaginal irrespective of the fact that she is HIV positive.
“What is important is that if she is HIV positive, she is on treatment not only for herself but also for the baby. So if we can bring the viral load down with ART, the probability that she will transmit to the baby is limited.”
The American College of Obstetricians and Gynaecologists also affirms that vaginal delivery is appropriate for HIV-infected pregnant women, who have been maintained on combined antiretroviral therapy and who have viral loads of 1,000 copies/mL or less at or near delivery.
Speaking further, the deputy director said it is also compulsory to test all pregnant women for HIV when they come to for antenatal clinic, stressing that it helps in the prevention of motor-to-child transmission of the disease.
According to the World Health Organisation, without any intervention, the risk of HIV transmission from a mother to her child during pregnancy, labour, delivery, or breastfeeding can be as high as 45 per cent.
As such, the WHO states that the identification of HIV infection should be immediately followed by an offer of linkage to lifelong treatment and care, including support to remain in care and virally suppressed, as well as an offer of partner services.
Nigeria faces a critical challenge in PMTCT of HIV and ensuring access to care for children living with HIV.
According to NACA, its epidemiological estimates indicate that 140, 000 children under 14 are living with HIV as of 2023, with 22,000 new infections and 15,000 AIDS-related deaths in children.
The agency disclosed that current PMTCT and paediatric HIV coverage remain alarmingly low at less than 33 per cent, far short of the 95 per cent target.
Meanwhile, the Joint United Nations Programme on HIV/AIDS established the 95-95-95 targets calling for 95 per cent of all people living with HIV to know their HIV status, 95 per cent of all people with diagnosed HIV infection to receive sustained antiretroviral therapy, and 95 per cent of all people receiving antiretroviral therapy to have viral suppression by 2030.