Antiretroviral prophylaxis (ARP) for prevention of mother to child transmission of HIV involves giving an antiretroviral drug to the mother starting at 28 weeks of gestation, again to the mother during labour and delivery, and to her baby immediately after its birth. The drug reduces the risk of transmission of HIV to the baby. It is different from the antiretroviral therapy (ART) given to the mother to treat her own HIV infection, depending on her eligibility criteria.
If an HIV-positive mother prefers and insists to deliver her baby at home, the current ARP drug that can be made available to her is called Nevirapine. When you know that an HIV-infected woman is near to giving birth at home, if you are authorised and trained to do so, you should give her a single dose of Nevirapine (200 mg) to take when true labour starts. It is better if you make the diagnosis of true labour and administer the drug yourself. Also, the baby should receive a single dose of Nevirapine within 3 days of being born. You should give this drug directly based on the baby's weight. You will learn how to do this in the Communicable Diseases Module in this curriculum.
For those who decide to give birth in a health centre or hospital, three types of ARP drugs need to be taken by the labouring mother as prophylaxis (AZT + Neverapine + Lamuvudine). The woman and her husband have to know that the three ARP drugs administered during labour provide better protection for the baby. Additionally, the baby will be given two drugs (AZT + Lamuvudine) for 1-4 weeks. Therefore, you have to encourage HIV-positive women to give birth in health centres or hospitals.
The ARP drugs reduce the risk of MTCT of HIV to the baby, but they don't treat the mother's HIV infection and don't improve her health. In some cases, the pregnant woman can start ART drug treatment for her HIV infection before she gives birth (if she is eligible). Therefore, you should try to encourage all HIV-infected pregnant women to go to the nearest health centre to check if they can start ART that will also protect their babies.