The most important factor that predicts the risk of MTCT is the level of HIV virological suppression at delivery and is dependent on adherence to an antiretroviral drug regime
To reduce MTCT all pregnant women with HIV should have commenced ARV therapy by 24 weeks
It takes time for ARV regimes to work. For the majority of cases presenting early, complete suppression should be achievable by 12-14 weeks after initiation of ARVs
If VL is undetectable and there are no other risks the woman’s management during labour and delivery should follow the same guidelines as for any pregnant woman
Women may require ongoing support and information in relation to the importance of adhering to treatment and reducing MTCT