On May 9, 2017, the Taiwan Centers for Disease Control (Taiwan CDC) announced 1 new HIV case in a baby. This is the second HIV case confirmed in a baby in Taiwan since the first case of mother-to-child HIV transmission that occurred in 2014. The mother is a Taiwanese national who resides abroad. She had not undergone any prenatal screening and HIV testing after pregnancy. She moved back to Taiwan for delivery during her third trimester. When she was tested positive for HIV during her prenatal screening in Taiwan, she was reported to the health authority. She was found to have a high HIV viral load. Although she was immediately given antiretroviral drugs and gave birth by cesarean section few weeks later, and the baby was cared for according to the guidelines for the postnatal management of the HIV-exposed neonates, given the post-exposure prophylaxis, being followed up regularly and was not breastfed, the baby still tested positive for HIV 2 months after birth. Hence, it is determined that the baby could have become infected with HIV during early pregnancy. Currently, the baby is in good health and has started taking antiretroviral drugs.
 

Under similar circumstances, the mother of the first case of mother-to-child HIV transmission did not undergo her first prenatal screening till the second trimester. 　She was tested positive for HIV during her prenatal screening and delivered her baby two weeks later by precipitous labor. Prior to her delivery, her HIV viral load was rather high. Immediately after birth, her baby was tested positive for HIV.

Pregnant women receiving HIV testing is critical in preventing mother-to-child HIV transmission. In order to protect infants and children from the threat of HIV, Taiwan CDC has implemented the “Comprehensive HIV Testing Program for Pregnant Women” since 2005. A prevention network of mother-to-child transmission has been established, focusing on three aspects: HIV screening, treatment, and nursing care to eliminate mother-to-child transmission. The first strategy: HIV screening for pregnant women during the first trismester, including free antenatal testing, and antepartum and neonatal rapid test. Over the recent 3 years, the HIV testing rate among pregnant women is as high as 99.7%. The second strategy: free post-exposure prophylaxis is provided to mothers throughout all three phases, including intrauterine, delivery and postpartum. The third strategy: corresponding nursing care, including free provision of infant formula, provision of post-exposure prophylaxis to babies with suspected HIV infection following 8-12 hours of birth, designated personnel to assist babies in taking antiretroviral agents in the first 6 weeks, and regular follow-up and testing of babies to prevent mother-to-child transmission.
 

Since the first confirmed HIV case in a woman that occurred in 1987, as of April 2017, a cumulative total of 1,960 HIV cases in Taiwan have been confirmed in women. The primary modes of HIV transmission include unsafe sex between opposite sexes (991 cases) and injecting drug use (913 cases). In the recent three years, unsafe sex between opposite sexes is the main cause of HIV transmission. When compared to other countries, although HIV infection among Taiwanese women is not as high, women are more vulnerable to HIV infection due to factors such as the structure of female genital organs and unequal gender relations. With Mother’s Day is fast approaching, Taiwan CDC would like to urge all women to get tested for HIV, especially expectant mothers, in order to ensure timely diagnosis and prompt treatment, prevent mother-to-child HIV transmission, and ensure the healthy development of babies. For more information, please visit the Taiwan CDC website at http://www.cdc.gov.tw or call the toll-free Communicable Disease Reporting and Consultation Hotline, 1922 (or 0800-001922).