A new study concludes some pregnant women in Canada are still passing HIV to their babies, despite the fact that this country has all the tools needed to stop it from happening at all.
Researchers combed through an HIV surveillance database and found 33 babies born in Canada between 2012 and 2021 were infected during pregnancy or delivery.
According to the World Health Organization, mothers living with HIV who don’t receive treatment have a 15 per cent to 45 per cent chance of transmitting the virus to their babies “during pregnancy, labour, delivery or breastfeeding.”
In Canada, “there’s no excuses to have any mother-to-child transmission,” said the new study’s senior author Dr. Fatima Kakkar, a pediatric infectious diseases specialist at CHU Sainte-Justine and the University of Montreal.
Antiretroviral treatments can be given to pregnant women to bring the amount of HIV virus in their blood down to an “undetectable” level, Kakkar said.
That brings the likelihood of transmitting the virus in utero down to less than one per cent, she said.
If a woman infected with HIV hasn’t had enough time to bring the amount of virus in her body down low enough, doctors can also give medication to the baby for several weeks after birth to prevent them from getting HIV.
Kakkar and her colleagues looked for reasons why the women whose babies became infected with HIV didn’t get the treatments they needed in a country where they should be readily available with “universal access to health care.”
One major issue is screening so that women know they’re infected in the first place and can begin antiretroviral treatment, which is usually a pill a day, Kakkar said.
“All pregnant women should be tested for HIV during pregnancy,” she said.
Sometimes that testing could be forgotten or health-care providers assume it was done by someone else, Kakkar said. In some cases, women may refuse the test.
Sometimes, women “haven’t been able to engage in care” to be diagnosed and treated during their pregnancies, she said. That could be because comprehensive care wasn’t available, if for instance the women are marginalized or because they live in remote areas.
In other cases, women who immigrated to Canada during their pregnancies didn’t have their HIV status discovered until it was too late to prevent transmission.
There are also women who tested negative at the beginning of their pregnancies but became infected by an HIV-positive partner later, Kakkar said.
In addition to ensuring all women have access to HIV screening and treatment during pregnancy, reducing stigma is also critical, Kakkar said.
That’s because many people are scared of the stigma that still surrounds HIV, so they may be reluctant to have the screening done. Doctors also need to test all of their pregnant patients and not make assumptions about their risk factors.
“The more we destigmatize HIV, the easier it will be for many more people to be tested and know their status,” she said.
Kakkar and her colleagues presented the findings at the Canadian Conference on HIV/AIDS Research that wrapped up on Sunday.