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Module Description

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The goal of this module is to prepare learners to manage the care of pregnant women, new mothers, and newborns living with HIV using an integrated approach to service delivery in order to eliminate mother-to-child HIV transmission (EMTCT). 

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Objectives

By the end of the module, the learner will be able to:

  1. Recognize the risks of HIV infection and acquisition during pregnancy and breastfeeding
  2. Identify appropriate ART options during pregnancy, delivery and breastfeeding
  3. Identify strategies to prevent mother-to-child transmission (PMTCT) in a mother presenting late in pregnancy with a high viral load, including ART prophylaxis for exposed infants
  4. Explain the importance of early infant diagnosis (EID)
  5. Discuss the unique needs of mothers and newborns related to HIV (IPE)
  6. Use a fishbone diagram to ascertain factors leading to low EID rates (QI)  

Optimizing Team-Based Care to Achieve High Quality HIV Care

Central to this module, facilitators should prompt all learners to consider how they can deliver care that fosters optimized team-based care to ensure high quality HIV care. Consider how the case enables learners to gain greater competency in the following domains:

  • Values and ethics: Work with individuals of other professions to maintain a climate of mutual respect and shared values.
  • Roles/responsibilities: Use the knowledge of one’s own role and those of other professions to appropriately assess and address the health care needs of patients and to promote and advance the health of populations.
  • Interprofessional Communication: Communicate with patients, families, communities, and professionals in health and other fields in a responsive and responsible manner that supports a team approach to the promotion and maintenance of health and the prevention and treatment of disease.
  • Teams and Teamwork: Apply the values and principles of team dynamics to build relationships and perform effectively in different team roles to plan, deliver and evaluate person-centered care and population health programs and policies that are safe, timely, efficient, effective and equitable. 

ABBREVIATIONS

AIDS Acquired Immune Deficiency Syndrome

ART Anti-retroviral therapy

AZT Zidovudine (also sometimes abbreviated ZDV)

DTG Dolutegravir

EFV Efavirenz

EID Early infant diagnosis

EMTCT Eliminate mother-to-child HIV transmission

HEU HIV exposed but uninfected infant

HIV Human Immunodeficiency Virus HIV-1

DNA PCR HIV-1 deoxyribonucleic acid polymerase chain reaction HIV-1

RNA PCR HIV-1 ribonucleic acid polymerase chain reaction (or HIV viral load)

INSTI Integrase Strand Transferase Inhibitor

NRTI Nucleoside Reverse Transcriptase Inhibitor

NNRTI Non-nucleoside Reverse Transcriptase Inhibitor

NVP Nevirapine

PI Protease inhibitor

PMTCT Prevention of mother-to-child transmission

RAL Raltegravir

QI Quality improvement

WHO World Health Organization