What if …
Q.71 What if the mother reports poor compliance to ART/ARVs, or if there is a break in the supply of NVP (stockout) to the mother and infant or non-adherence for other reasons?
Health workers should identify the underlying reasons for the poor compliance or non adherence and try to immediately provide ARVs, even as an interim measure, and restore ARV supplies. If there is a break in supply, issues in the system should be reviewed and corrected. Counselling to the mother may help to resolve other issues, such as an un-founded belief that the drugs are harming the baby, or fears about disclosure in the family or community.
If poor compliance cannot be resolved:
- If the infant is less than 6 months of age and breastfeeding, the mother should be counselled and supported to continue exclusive breastfeeding. Even if she has begun mixed feeding, she would probably be able to revert to exclusive breastfeeding if she is given sufficient support and understands the importance of doing so.
- If the infant is 6 months of age up to one year, then counselling should focus on whether the small risk of HIV transmission through breastfeeding is less than the risk of malnutrition or other infectious diseases if the infant is not breastfed.