|
|
Abstract
The political economy of the prevention of postnatal transmission of HIV
A Castro, J S Mukherjee
Harvard Medical School, Boston, MA, United States
Issue: Policy recommendations for the prevention of postnatal transmission of HIV in developing countries focus heavily on the use of breastmilk supplements to prevent HIV transmission. While such recommendations often consider the use of ARV monotherapy for the prevention of MTCT, they have been developed without considering the possibility of providing HAART to mothers.
Description: Since the finding that HIV could be transmitted through breastmilk, several infant feeding recommendations have been developed to prevent postnatal transmission of HIV. However, the recommendation for the use of breastmilk substitutes without considering the provision of treatment of the HIV+ mother both jeopardizes the immunologic and nutritional status of the child and contributes to a public health system that creates an exponential rise in the number of orphans.
Lessons learned: The scientific and social assumptions underlying MTCT trials lack an analysis of how infant feeding recommendations are developed and neglect the social factors that prevent HIV+ women from having more than one feeding option. The majority of the public health and policy literature on MTCT reflects a disproportional effort on prophylactic measures in the absence of those that promote the health and survival of the family unit through increased access to HAART - which would decrease perinatal MTCT and protect the infant from infection throughout the postnatal period, even if breastfeeding is determined to be the safest option. As a comprehensive global AIDS strategy is developed, focus on the reduction of maternal viral load will also decrease the high rate of adult transmission in the community and prolong the survival and social contributions of women of childbearing age.
Recommendations: As more funding is available to treat HIV in resource-poor settings, research and health policy will need to be focused on treatment, both as a means of improving women’s health and as a way of reducing MTCT.
The XIV International AIDS Conference
Abstract no.
TuPeE5065
Suggested Citation
" A Castro, et al.
The political economy of the prevention of postnatal transmission of HIV.
Poster Exhibition:
The XIV International AIDS Conference:
Abstract no.
TuPeE5065"
|
|
|