We have chosen The HIV/AIDS- epidemic in SSA what are the consequences for antenatal care? as our approach. We have looked upon the present situation of the HIV/AIDS- epidemic, the present use and availability of antenatal care in SSA and how the HIV/AIDS- epidemic affects antenatal care in the same region.
The ongoing HIV/AIDS- epidemic is a disaster for SSA. Over 40 million people are infected worldwide, two thirds live in SSA. Three million people die each year, and 700 000 children are infected from their mothers each year. The epidemic is at different stages in the different countries, but the consequences will be felt in the decades to come. The economic and social consequences are serious. The pathophysiology and clinical aspects of the infection are discussed. The transmission, both sexually, vertically and accidentally are also discussed. The main chapter is about prevention and treatment, pointing especially on counselling and antiretroviral treatment. ART is at the moment available for most people in SSA, but there is hope.
Antenatal care is actually available to most women in SSA, and over half of the women follow the WHO guidelines with four visits. Antenatal care is strongly related to poverty, cultural and religious factors, education, infrastructure and the local reproduction pattern.
HIV is at present the most common complication of pregnancy, and the infection and pregnancy interact. Mother- to- child transmission can be reduced to a minimum (< 1 %) with chemoprophylaxis, caesarean section and avoiding of breastfeeding.