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. 2009 Apr;99(4):631-7.
doi: 10.2105/AJPH.2007.114421. Epub 2008 Aug 13.

Preventing mother-to-child transmission of HIV in resource-limited settings: the Elizabeth Glaser Pediatric AIDS Foundation experience

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

Preventing mother-to-child transmission of HIV in resource-limited settings: the Elizabeth Glaser Pediatric AIDS Foundation experience

Allison Spensley et al. Am J Public Health. 2009 Apr.

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 6(1/2) 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 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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Figures

FIGURE 1
FIGURE 1
Selected indicators showing cumulative results of the Elizabeth Glaser Pediatric AIDS Foundation's program for the prevention of mother-to-child transmission (PMTCT) of HIV, through June 30, 2006. Note. Data shown (left to right) are as follows: women eligible for PMTCT services in antenatal care (ANC) and in labor and delivery ward; women receiving counseling; women tested for HIV; women receiving their test results; women who were HIV positive; women receiving antiretroviral (ARV) prophylaxis; infants receiving ARV prophylaxis.
FIGURE 2
FIGURE 2
Number of women in the Elizabeth Glaser Pediatric AIDS Foundation's program for the prevention of mother-to-child transmission (PMTCT) of HIV who were eligible for PMTCT services in antenatal care or labor and delivery ward, received counseling, received HIV testing, and received HIV test results, by time interval. Note. ANC = antenatal care.
FIGURE 3
FIGURE 3
Number of women in the Elizabeth Glaser Pediatric AIDS Foundation's program for the prevention of mother-to-child transmission who tested positive for HIV and the number of women and infants who received antiretroviral (ARV) prophylaxis, by time interval.
FIGURE 4
FIGURE 4
Selected indicators showing results during the start-up year (2000) and most recent year for which data are available (July 1, 2005–June 30, 2006): the Elizabeth Glaser Pediatric AIDS Foundation's program for the prevention of mother-to-child transmission (PMTCT) of HIV. Note. Data shown (left to right) are as follows: women eligible for PMTCT services in antenatal care (ANC) and in labor and delivery ward; women receiving counseling; women tested for HIV; women receiving their test results; women who were HIV positive; women receiving antiretroviral (ARV) prophylaxis; infants receiving ARV prophylaxis.
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