The number of women with HIV giving birth in Minnesota tripled over the past decade. However, mother-to-child (MTC) HIV infections have been nearly eliminated during the same timeframe, thanks to a collaborative effort by hospitals, obstetricians, and a team of perinatal HIV experts at Children's Hospitals and Clinics of Minnesota (CHCM).
CHCM trains doctors in how to screen pregnant women, provide prenatal care, and offer the best delivery strategies for HIV-infected mothers. Rapid testing can be done at the time of delivery if the woman's HIV status is unknown. Up to half of HIV-positive pregnant women are unaware they carry the virus.
The risk of MTC transmission has been drastically cut through the program. The women receive antiretroviral treatment before delivery; the newborn is given ARVs at birth. Many women choose to have a caesarian section and do not breastfeed to eliminate the risk of infection through breast milk. The collaborative program has cut the rate of MTC infection in the state to below 1 percent since 2000.
Sixty births to HIV-positive women were recorded in Minnesota in 2009, and in 29 cases the mother was born in Africa. For these women, not breastfeeding is especially difficult, said Dr. Laura Hoyt, director of the CHCM program.
Breastfeeding is both economically cheaper and an African cultural norm, and some mothers fear that bottle feeding would be a visual clue to their HIV status. Of two perinatal HIV transmissions during the past six years, one likely was due to breastfeeding, Hoyt said.