AEGiS-13IAC: Pilot program to implement short-course AZT to reduce perinatal HIV transmission in Northeastern Thailand, 1998ndash;1999.

13th International AIDS Conference

Durban, South Africa - July 9-July 14, 2000

Pilot program to implement short-course AZT to reduce perinatal HIV transmission in Northeastern Thailand, 1998ndash;1999.

Int Conf AIDS 2000 Jul 9-14; 13:(abstract no. WeOrC553)

Kanshana S, Thewanda D, Teeraratkul A, Limpakarnjanarat K, Amornwichet P, Kullerk N, Mastro TD, Simonds RJ
S. Kanshana, Bureau of Health Promotion, The HIV/AIDS Collaboration, DMS 6 Bldg Ministry of Public Health, Tivanon Road, Nonthaburi 11000, Thailand, Tel.: +66 2 591 8358, Fax: +66 2 591 5443, E-mail: rxs5@cdc.gov

BACKGROUND: The Thai Ministry of Public Health began a pilot program in July 1998 in 7 northeastern provinces (Region 7). The program provides counseling and HIV testing for all pregnant women, and antenatal zidovudine (ZDV) and infant formula for all HIV-infected pregnant women and their children in 89 public hospitals.

METHODS: Region 7 has 1 regional, 6 provincial, and 82 district hospitals; all participate in the program. Data are collected using monthly summaries of project logbooks and simple data forms in antenatal clinics and delivery rooms. Other information was collected through site visits, workshops, and a mail survey.

RESULTS: From July 1998 through September 1999, 1292 (97%) of 1335 expected monthly reports were received. Of 95,253 women who gave birth, 94,254 (98.9%) had antenatal care, 65,545 (69.5%) in the same district and 28,709 (30.5%) outside the district where they gave birth. HIV test results were available at delivery for 61,186 (64.2%) women, 552 (0.9%) of whom tested positive. Of these HIV-infected women, 369 (66.8%) participated in the short-course ZDV program and 8 (1.4%) received ZDV from other sources. The proportion of women whose HIV test results were known and the proportion of HIV-infected women who received ZDV increased significantly during the 15 months. Reasons for women not being tested included lack of counseling training early in the program, test kit unavailability in some sites, and refusal because of cost. Reasons for women not getting ZDV included starting ANC late, moving out of the district, premature delivery, or refusal because of family concerns.

CONCLUSIONS: A mother-infant HIV prevention program using short-course antenatal ZDV was quickly implemented in a large region of Thailand. This successful experience is leading to national implementation of a perinatal HIV prevention program in Thailand and may prompt other developing countries to start similar programs.

Keywords: AEGIS, Zidovudine, HIV Infections, Prenatal Care, HIV Seropositivity, Developing Countries, Counseling, Feasibility Studies, Delivery, Obstetric, Infant Food, Thailand, Human, Female, Child, Infant, Pregnancy, transmission, surgery
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WeOrC553