The CDC estimates that 1.2 million people in the United States live with HIV. The highest risk of getting HIV comes from blood transfusions, but the most common method of infection in children is HIV transmission from the mother–either through pregnancy, labor and delivery, or breastfeeding. This risk can be immensely reduced from about 45% to 1% by taking antiretroviral medication during pregnancy, which keeps the virus from growing and slows down the progression of the disease.
The WHO announced at the end of June that less than 2% of children born to mothers with HIV in Cuba have the virus, making Cuba the first country to achieve elimination of mother-to-child HIV transmission. This is the lowest percentage achievable today through modern treatment and thus is considered elimination.
So how’d they do it? Through constant monitoring during all of the steps of the childbirth process for all pregnant women living with HIV. The first step is to confirm the presence of the virus and prescribe the mother with antiretroviral medications. The baby is delivered through cesarean section, as the chances of HIV exposure is highest during delivery when the baby can be exposed to the mother’s bodily fluids. The doctors provide medication for the child, follow up with the child for 18 months, and recommend that the mothers not breastfeed their children to keep the children from being exposed to HIV. Early detection and treatment is quite important in HIV treatment, so this is an effective way of not only reducing the chances of HIV infection, but also quickly catching any signs of exposure.
Cuba is most likely not alone in this achievement–Sonja Caffe of the Pan-American Health Organization (PAHO) believes that several other countries, such as the United States, have most likely eliminated transmission but have not yet received official validation from the WHO or PAHO.
Feature Image Source: John Moore
However, there are still countries, such as Pakistan and Yemen, where only 9-11% of pregnant women with HIV are taking antiretrovirals, indicating that there is still work to be done. The Joint United Nations Programme on HIV/AIDS (UNAIDS) is working towards the goal of ending the AIDS epidemic by 2030, so hopefully one day, “elimination” will refer to completely stopping mother-to-child HIV transmission as more people have access to antiretroviral therapy.
Feature Image Source: Frank de Kleine