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AJPH First Look, published online ahead of print Aug 13, 2008
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American Journal of Public Health, 10.2105/AJPH.2007.114421

Research and Practice

Preventing Mother-to-Child Transmission of HIV in Resource-Limited Settings: The Elizabeth Glaser Pediatric AIDS Foundation Experience

Allison Spensley 1*, Tabitha Sripipatana 1, Abigail Norris Turner 2, Chuck Hoblitzelle 1, Joanna Robinson 1, Catherine Wilfert 1, The Elizabeth Glaser Pediatric AIDS Foundation Prevention of Mother-to-Child Transmission of HIV Group 1

1 Elizabeth Glaser Pediatric AIDS Foundation
2 University of North Carolina, Chapel Hill

* To whom correspondence should be addressed. E-mail: allison{at}pedaids.org.


  Abstract

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 61/2 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 or 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.

Key Words: Global Health, HIV/AIDS, Maternal and Infant Health, Prevention




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[Abstract] [Full Text] [PDF]


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