Lian Lian (pseudonym) was tested HIV positive during the first trimester of pregnancy in her twenties. Feeling helpless at first, she was immediately referred to a designated hospital for comprehensive antiretroviral treatment and regular medical follow up. With the best care provided by doctors and nurses, the risk of mother-to-child HIV transmission was largely reduced and she delivered a healthy baby boy. Holding her child, Lian Lian said, “The only thing I know at the moment is to protect my baby. The best gift I could give him is to cherish his life” .
By the end of November 2008, a total of 27 vertically transmitted HIV-infected newborns have been reported in Taiwan. In recent years, the case number has been decreasing: 5 caseswere reported in 2005, 4 cases were reported in 2006, and 0 case has been reported since 2007. A newborn delivered by an HIV-infected mother should be followed up regularly until the age of 18 months, and HIV acquisition can be excluded if HIV antibody tests were negative twice after the age of 12 months. Since 2005, a total of 95 newborns have been successfully HIV excluded.
Many people have the wrong impression that HIV-infected mothers always give birth to HIV-infected children. In fact, mother-to-child HIV transmission occurs during three phases: intrauterine, delivery and breastfeeding. If antiretroviral treatment were to be provided throughout all three phases, the baby’s risk of HIV infection is reduced greatly from 45% to <2%.
In order to protect children from the threat of HIV, Taiwan CDC has implemented policies for prevention of mother-to-child HIV transmission beginning 2005. A comprehensive prevention network of mother-to-child transmission has been established, focusing on three aspects: expanded HIV screening, free antiretroviral treatment, and corresponding nursing care, to eliminate mother-to-child transmission. The first strategy, expanded HIV screening, includes free antenatal testing, and antepartum and neonatal rapid test. The second strategy, free antiretroviral treatment, is provided to mothers throughout all three phases: intrauterine, delivery and postpartum. The third strategy, corresponding nursing care, includes free provision of infant formula, regular follow up and testing, and designated personnel to assist babies in taking antiretroviral agents in the first 6 weeks.