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This Article Figures Only Full Text Full Text (PDF) Data Supplement All Versions of this Article: AJPH.2007.114421v1 99/4/631    most recent Submit a response View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Spensley, A. Search for Related Content PubMed PubMed Citation Articles by Spensley, A. Related Collections Global Health HIV/AIDS Other Maternal and Infant Health Prevention

Allison Spensley, MPH, MSW, Tabitha Sripipatana, MPH, Abigail Norris Turner, PhD, Chuck Hoblitzelle, BA, Joanna Robinson, MSc, Catherine Wilfert, MD for The Elizabeth Glaser Pediatric AIDS Foundation Prevention of Mother-to-Child Transmission of HIV Group

Allison Spensley, Tabitha Sripipatana, Chuck Hoblitzelle, Joanna Robinson, and Catherine Wilfert are with the Elizabeth Glaser Pediatric AIDS Foundation, Santa Monica, CA. Abigail Norris Turner is with the University of North Carolina, Chapel Hill.

Correspondence: Requests for reprints should be sent to Allison Spensley, MPH, MSW, 1140 Connecticut Ave NW, Suite 200, Washington, DC, 20036 (e-mail: allison{at}pedaids.org).

Objectives. In September 1999, the Elizabeth Glaser Pediatric AIDS Foundation initiated a multicountry, service-based programmatic effort in the developing world to reduce perinatally acquired HIV infection. We review 6 years of one of the world's largest programs for the prevention of mother-to-child transmission (PMTCT) of HIV.

Methods. Each PMTCT facility records patient data in antenatal clinics and labor and delivery settings about counseling, testing, HIV status, and antiretroviral prophylaxis and submits the data to foundation staff.

Results. More than 2.6 million women have accessed foundation-affiliated services through June 2006. Overall, 92.9% of women who received antenatal care or were eligible for PMTCT services in labor and delivery have been counseled, and 82.8% of those counseled accepted testing. Among women identified as HIV positive, 75.0% received antiretroviral prophylaxis (most a single dose of nevirapine), as did 45.6% of their infants.

Conclusions. The foundation's experience has demonstrated that opt-out testing, supplying mothers with medication at time of diagnosis, and providing the infant dose early have measurably improved program efficiency. PMTCT should be viewed as an achievable paradigm and an essential part of the continuum of care.

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