PHM-Exch> WABA/ABM Joint Statement on World AIDS Day 2018: Know Your Status : a matter of HIV-free survival

[Claudio Schuftan]

*WABA/ABM Joint Statement on World AIDS Day 2018: Know Your Status : a
matter of HIV-free survival *

Every week, around 7000 young women aged 15–24 years become infected with
HIV. In sub-Saharan Africa, three in four new infections are among girls
who are twice as likely to be living with HIV than men.



On World AIDS Day 2018, UNAIDS is focusing on HIV testing. Testing for HIV
allows you to seek HIV treatment if you are HIV-positive or to protect
yourself if you are HIV-negative. Knowing your HIV status gives you the
power to take control of your health and well-being.



HIV treatment, care, and support provide the means to scale up prevention
of vertical transmission to the next generation, cut new infection rates
and save the lives of mothers. HIV testing is usually the entry point for
HIV prevention or treatment. Early detection of the HIV status of women
will provide an opportunity to start antiretroviral drug treatment.



Due to the high risk of acquiring HIV during pregnancy, all pregnant women
not living with HIV should be retested in the third trimester, during
labour and/or during the postpartum period. Early treatment enables
pregnant women to receive prompt antiretroviral treatment (ART) for
themselves and early antiretroviral (ARV) prophylaxis to reduce the risk of
transmission of HIV to their babies during pregnancy, birth, and
breastfeeding.



The risk of vertical transmission is particularly high if a woman acquires
a new HIV infection, leading to high viral levels in her blood or milk
while she is pregnant or breastfeeding. It is strongly recommended that all
HIV-exposed infants have virological testing at 4-6 weeks or at the
earliest opportunity thereafter. Early Infant Diagnosis (EID) of HIV
infection is critical to ensure optimal treatment outcomes for children.



With no interventions, ~30-40% of infants born to HIV-positive mothers may
be infected during pregnancy, birth, after birth, or during
breastfeeding. Maternal/infant
ARV regimens during pregnancy and breastfeeding greatly reduce vertical
transmission of HIV. Postnatal transmission of HIV (i.e. through
breastfeeding) can be further reduced to 0-1% if pregnant women living with
HIV have access to effective lifelong  ART upon diagnosis.



Infant mortality in the first year is very high in untreated HIV-infected
infants. HIV-exposed infants should get early HIV testing with prompt
return of results, rapid initiation of treatment and receive continued
breastfeeding in order to improve survival. Breastfeeding also protects
against other frequent causes of preventable child mortality such as
pneumonia, diarrhoeal diseases, and undernutrition.



Even when ARVs are not available, breastfeeding may still provide infants
born to HIV-infected mothers with a greater chance of HIV-free survival.
Mothers should be counselled to exclusively breastfeed in the first six
months of life and continue breastfeeding thereafter unless environmental
and social circumstances are safe for and supportive of replacement feeding.



The World Alliance of Breastfeeding Action (WABA) has published the second
edition of the HIV Kit - Understanding International Policy on HIV and
Breastfeeding. This comprehensive resource seeks to inform about the
concepts and recommendations for dealing with infant feeding and HIV-free
survival. The Kit was developed in close cooperation with international
reviewers, and endorsed by the Academy of Breastfeeding Medicine. The
complete Kit is now available *online
<http://waba.org.my/understanding-international-policy-on-hiv-and-breastfeeding-a-comprehensive-resource/>*.




World AIDS Day 2018 reminds us to make HIV testing a priority. Early
testing/detection of HIV will enable people to make informed decisions
about breastfeeding in the context of HIV to ensure HIV-free survival.



References:

*World AIDS Day: Know Your Status, UNAIDS, 2018
<https://knowyourstatus.unaids.org/>*

*Understanding International Policy on HIV and Breastfeeding: a
comprehensive resource, WABA June 2018
<http://waba.org.my/understanding-international-policy-on-hiv-and-breastfeeding-a-comprehensive-resource/>*

*Fact sheet - Latest statistics on the status of the AIDS epidemic, UNAIDS
July 2018
<http://www.unaids.org/sites/default/files/media_asset/UNAIDS_FactSheet_en.pdf>*


For more information, please contact:

WABA Liaison Person:
Pei Ching
peiching.chuah at waba.org.my <aida.redza at waba.org.my>

ABM Liaison Person:
Elien Rouw
elienrouw at t-online.de  <aida.redza at waba.org.my>


*Pei Ching*
*Programme Coordinator, Health and Information *

*World Alliance for Breastfeeding Action*
Email: waba at waba.org.my
Websites: www.waba.org.my
             www.worldbreastfeedingweek.org
             www.breastfeedinggateway.org
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