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Mother to child transmission

Mar 29, 2006

Hi Dr. Bob. Let me start off by saying THANK YOU for all you do. You're amazing and I read your posts every day. The reason I'm writing is because I have a very important question.

I do HIV Prevention for women in Alameda County. I recently came across info on the Women's Forum of that I don't understand. I asked a question to them on Mar 14 but no response for 2 weeks now.

The Dr. said that transmission from mother to child can happen DURING the pregnancy. At my CHOW training we were told that this is very rare and usually only happens during high risk pregnancies or if the sac is punctured. As far as I understood, it's mostly transmitted during vaginal birth or from breast milk. Can you please clarify so I can give my clients the accurate info. I guess a simpler way to put it - how exactly is HIV transmitted from mother to child? Your response is much appreciated. Keep up the good work.

And thanks for the laughs. Some posts and responses make me laugh until I almost cry and definitely make the day go by much quicker!


Response from Dr. Frascino


I lived in Alameda when I first moved to the West Coast. I still remember jogging on the beach with a great view of San Francisco every morning before rounds at the hospital.

OK, enough memory lane and on to your question!

Infants may acquire HIV antepartum (in utero), intrapartum (during birth) or postpartum (after birth via breastfeeding). For women who do not breastfeed, intrauterine transmission previously accounted for 25% to 40% of infections, while delivery accounted for 60% to 75%. [MMWR 2001; 50(RR-19):63] More recent data from the WITS study in the U.S. shows in utero transmission now accounts for more than half of mother-to-child transmission (MTCT) in the U.S. (J. Acquir Immune Defic Syndr 2005; 38:87). The risk of HIV transmission with breastfeeding is 10% to 16%. This risk is greatest in the first four to six months.

I'm glad you enjoy the forum. I'll repost a few classics from the vault to hopefully start your day with a chuckle.

Stay well.

Dr. Bob

Will Procrit help? Jun 16, 2005

Hey Bob,

Feeling really tired and run down lately. Will Procrit improve my energy level? I'm not HIV positive and have no idea if I'm anemic but I sure feel low. I broke up with my girlfriend. She caught me in bed with a guy. It really wasn't going to work out with her anyway. As if things couldn't get any worse, I was laid off from my job and for financial reasons and now I've had to move back in with my mother. My ex called her and told her about my sexual adventures. Mother who is Bapist didn't take the news well. She refuses to let gay books or movies in the house. She's even screening my calls. Thank god she doesn't understand computers or the internet! So what do you think Dr. Bob, should I give Procrit a try?


Response from Dr. Frascino


OK, Dirk, sorry, but it sucks to be you. Your girlfriend finds you mano-a-mano with the UPS guy making a special delivery in the boudoir, so she calls your mother??? Dude, you are so right. It would not have worked out with Little Miss Tattletale.

And then after getting laid, you get laid off and have to move back home with the Church Lady? Damn, no wonder you're feeling down and out (or should that be down about being outted?).

Regarding Procrit, it's a wonderfully effective medication to treat certain types of anemia; however, you most likely are not anemic. To find out, you would need a simple blood test called a hemoglobin level. If you have less than 14 g/dL of hemoglobin, you are anemic. But again, I strongly doubt this is your problem. Your lack of energy is most likely due to situational depression. After all, Dude, you just had to move back in with Mom and now you have to sneak gay stuff into your bedroom? How about this forum? Do you have to sneak us in as well? We love it when guys sneak us into their rooms. It's so Baptist-sleep-away camp! Hey, there's an idea. Maybe your mom could send you to Baptist-sleep-away camp. Then you'd have two whole weeks of gay freedom! But if that doesn't work out, for the time being I guess you'll just have to grab your dick and double click.

Good luck, Dirk. I think you may need it.

Dr. Bob

I don't know if I got a lap dance. Jan 20, 2005

Hello - I was just wondering what you consider a lap dance. I had a naked chick rubbing her pussy all over the tip of my dick. I was wearing uderwear and a bathing suit. (1) is that what you call a no risk lap dance. (2) whats my risk? Thanks

Response from Dr. Frascino


Not only do you not know what a lap dance is, but apparently you can't tell the difference between a swimming pool and a titty-bar. Why were you wearing a bathing suit and your Calvins??? Oh, never mind.

If a naked chick is rough riding your fully dressed big bopper, chances are you are indeed getting a lap dance, especially if she's wearing red cha-cha heels, there is loud bad disco music playing and a burly sweaty dude named Bruno is sitting nearby with a raincoat in his lap.

I would consider your HIV risk to be essentially nonexistent. I think your biggest worries should be 1) Bruno and 2) being busted by the fashion police.

Stay well.

Dr. Bob

Dr. B show me some love
Please - Don't keeping searching for symptoms - Get tested

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