04/12/2025
I have noticed that a lot of people don't have knowledge about MCT. MCT has been changing for some time now and guidelines keep on changing. Currently we are at Elimination of Mother to Child Transmission (EMTCT). Meaning chances of transmitting the virus to the baby in the womb, at birth and during breastfeeding is eliminated.
When a pregnant woman starts antenatal they test them for HIV. If found positive they are IMMEDIATELY commenced on ART. If they are already positive they continue them on ART. They will check the mother's viral load every 3 months to make sure the viral load is suppressed (preferably undetectable). During childbirth the mother's viral load will determine the mode of delivery i.e. vaginal delivery or C-section (with the exception of other complications that may happen). When the baby is born, the baby is put on ARVs prophylaxis (whether the mode of delivery was through vaginal delivery or C-section). The minimum is 3 months for babies born to mothers whose viral load is Undetectable. But if the viral load is detectable prophylaxis may be extended. An HIV positive mother who has a suppressed viral load is allowed to breastfeed. The first 6 months they do exclusive breastfeeding and introduced solids at 6 months. Meaning they ONLY give breast milk for 6 months. An HIV positive mother is now allowed to breastfeed up to 2 years provided they are following the EMTCT guidelines. Meanwhile they will have introduced septrin at 6 weeks. Septrin is a prophylaxis against bacterial infections especially pneumonia and it's NOT an ARV. This is where a lot of people get confused. They think septrin is a prophylaxis against HIV. It does not prevent your baby from getting infected with HIV. What prevents your baby from getting infected with HIV is your viral load as an HIV positive mother. So instead of worrying about your baby having missed their dose of septrin, you should worry about your viral load. That is the most important thing in protecting your baby from getting infected. As long as you keep your viral load suppressed then you are protecting your baby from getting infected. I am not sure on the testing procedure on babies now but I remember it used to be at birth, 6 weeks, 6 months, 9 months, 1 year, 1 year 6 months and lastly at 2 years.
Note
Consult your ART providers for guidance and follow EMTCT guidelines which you are given at your health facility.
