"Aimeiyi" prevention and treatment knowledge series - AIDS

AIDS, the full name of which is "Acquired Immune Deficiency Syndrome", is an infectious disease caused by the human immunodeficiency virus (HIV) infecting the human immune system, resulting in partial or complete loss of the immune system's function, followed by a series of infections and various tumors.

About Pregnancy

(1) When providing pre-pregnancy counseling and health care services, close attention should be paid to and respect should be given to the birth plans of women of childbearing age, and professional guidance should be provided on how to take safety measures in life to avoid unplanned pregnancies.

(2) A single-positive family refers to a family in which one spouse is HIV antibody positive and has been confirmed to be infected with HIV, while the other spouse is HIV antibody negative and has not been infected. Due to the high incidence of other reproductive tract diseases among HIV-infected people, sexual partners should be screened for sexually transmitted diseases when preparing for pregnancy, and if a sexually transmitted disease is found, treatment should be provided as soon as possible.

(3) In the case of natural conception, the HIV-negative party must undergo HIV antibody testing after unprotected sexual intercourse to rule out HIV transmission between spouses.

When is screening done?

Screening tests before or in early pregnancy can help detect and diagnose the virus as early as possible. Once the infection is confirmed, you need to carefully consider whether to continue the pregnancy. If you choose to continue the pregnancy, you need to take anti-HIV drugs as soon as possible under the guidance of a doctor in a designated hospital, perform corresponding mother-to-child transmission prevention as soon as possible, and conduct regular check-ups and follow-up.

Treatment and follow-up of infected pregnant women

(1) Follow-up during pregnancy: Regardless of the viral load or CD4 cell count, HIV-positive pregnant women should start antiviral treatment as soon as possible once they are found to be infected with HIV to reduce the risk of perinatal HIV vertical transmission. Pregnant women receiving antiviral treatment need to closely monitor their viral load. In the early stage of treatment, HIV viral load testing should be performed once a month until the viral load is undetectable, and then once every 3 months. HIV RNA testing is required again at 34 to 36 weeks of pregnancy. The test results are an important basis for determining the mode of delivery and the post-exposure prevention plan for newborns.

(2) Postpartum follow-up: HIV-positive mothers should not stop antiviral treatment after delivery. If the original regimen has achieved an undetectable level of HIV RNA, the original regimen can be used to continue treatment. If the original regimen cannot achieve virological suppression after more than half a year of medication, HIV resistance testing should be performed and the medication should be changed based on the test results.

Treatment and follow-up of exposed children

Newborns born to pregnant women infected with HIV can effectively prevent mother-to-child transmission of HIV by starting to take antiviral drugs within 6 hours after birth and adhering to the full course of treatment.

Newborn follow-up: Children born to pregnant women with AIDS should be followed up and given physical examinations at 1, 3, 6, 9, 12 and 18 months of age. Blood samples should be collected within 48 hours, 6 weeks and 3 months for early diagnosis (nucleic acid testing). HIV antibodies should be tested at 12 and/or 18 months of age, and any symptoms of infection should be observed.

Labor and delivery management

Cesarean section is recommended for termination of pregnancy to further reduce the risk of transmission.

About Breastfeeding

(1) Children born to HIV-infected pregnant women should be fed scientifically. Artificial feeding is encouraged in areas or individuals where conditions permit, and breastfeeding should be avoided.

(2) Medical staff should discuss infant feeding issues with HIV-positive pregnant women and their families, including the acceptance of artificial feeding, feeding knowledge and skills, the cost, the ability to obtain nutritionally balanced and safe formula milk on a continuous and stable basis, and the ability to obtain continuous guidance and support from medical staff.

(3) For families where conditions permit, artificial feeding is recommended and guided as a priority.

About contraception

Correct use of condoms is currently the most effective way to prevent HIV transmission. It can effectively prevent HIV and other sexually transmitted diseases and reduce mother-to-child transmission of HIV. Improper use of condoms has a relatively high contraceptive failure rate. It is recommended to use other highly effective contraceptive methods on top of condoms, such as intrauterine devices, subcutaneous implants, and other double protection contraceptives.

Reproductive management

Pre-pregnancy counseling: HIV viral load and immune function assessment should be performed before planning to have another child, ensuring that the viral load is controlled at an undetectable level.

Key Points

Antiviral treatment during pregnancy and avoiding breastfeeding are key to ensuring that the viral load is kept low.

Common misunderstandings clarified

HIV infected people cannot have healthy children

mistake!

The success rate of mother-to-fetal transmission prevention under standardized treatment exceeds 95%.