AIIMS CRE 2025
Community Health Nursing
Easy
What is the key strategy under NACP to prevent mother-to-child transmission of HIV?
Appeared in: AIIMS CRE 2025
Explanation
- The core strategy of the Prevention of Parent-to-Child Transmission (PPTCT) program under NACP is providing lifelong Antiretroviral Therapy (ART) to all HIV-positive pregnant and breastfeeding women.
- ART works by suppressing the maternal viral load to undetectable levels, which is the most effective method to prevent HIV transmission to the infant during pregnancy, childbirth, and breastfeeding.
- This approach is part of the 'Test and Treat' policy, where treatment is initiated immediately upon diagnosis, regardless of the mother's CD4 count or WHO clinical stage, to maximize prevention benefits.
Why Other Options Were Wrong
- Option A: Promoting breastfeeding without ensuring the mother is on effective ART is dangerous, as the HIV virus can be transmitted through breast milk. The safety of breastfeeding is entirely dependent on the mother's viral load being suppressed by ART.
- Option B: Condoms are a primary strategy for preventing the sexual transmission of HIV and other STIs between partners. They play no role in preventing vertical (mother-to-child) transmission during pregnancy, labor, or delivery.
- Option D: Increasing testing centers is a crucial logistical step to identify HIV-positive pregnant women, but it is not a preventive intervention in itself. Testing enables the strategy, but the strategy itself is the treatment that follows a positive diagnosis.
Related Visual
- Visual 1: Flowchart illustrating the cascade of PPTCT services: from antenatal check-up and HIV testing to ART initiation for the mother and ARV prophylaxis for the infant.
- Visual 2: Infographic comparing the risk of mother-to-child HIV transmission with and without ART, showing a reduction from approximately 20-45% to less than 5%.
Clinical Relevance
- Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Prevention of Mother-to-Child Transmission (PMTCT) of HIV under the National AIDS Control Programme (NACP) as background academic context rather than a clinical decision trigger.
- Nurses are central to the success of the PPTCT program. Responsibilities include counseling pregnant women to accept HIV testing, ensuring strict adherence to ART, educating on safe infant feeding practices, and coordinating follow-up care for both mother and child.
- Early infant diagnosis (EID) using HIV-DNA PCR at 6 weeks of age is critical for HIV-exposed infants to determine their status and initiate treatment promptly if infected.
- What if? If a pregnant woman tests positive for HIV late in her third trimester, the strategy remains the same: initiate ART immediately for the mother and ensure ARV prophylaxis for the infant at birth. Every day on treatment reduces the transmission risk.
How to Approach the Question
- First, identify the core of the question: It asks for the 'key strategy' to prevent 'mother-to-child' HIV transmission under NACP.
- Analyze the specific transmission route in question: This is vertical transmission, which can occur during pregnancy, birth, or breastfeeding.
- Evaluate each option's effectiveness against this specific transmission route.
- Recognize that 'Condom distribution' prevents sexual (horizontal) transmission, not vertical transmission. This option is incorrect.
- Understand that 'Increasing testing centers' is a necessary step for identification but does not, by itself, prevent transmission. It enables the strategy but isn't the core strategy.
- Consider 'Promoting breastfeeding'. While part of the overall care plan under specific conditions (mother on ART), it carries a risk of transmission if the virus is not suppressed. Therefore, it cannot be the key prevention strategy.
Concept Tested & Keywords
- Concept Tested: Prevention of Mother-to-Child Transmission (PMTCT) of HIV under the National AIDS Control Programme (NACP).
- Stem keywords: NACP, prevent, mother-to-child transmission, HIV
- Lead-in keywords: key strategy
- Clinical cues: Age/sex group narrows the expected diagnosis, intervention, or normal reference range.
- Negative lead-in flag: false
Question ID
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Practise the full AIIMS CRE 2025
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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- Which action reduces the risk of mother-to-child transmission of HIV during childbirth?
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