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Preventing Mother-to-Child HIV Transmission
The First Year of Thailand's National Program
Pornsinee Amornwichet, MPH;
Achara Teeraratkul, MD;
R. J. Simonds, MD;
Thananda Naiwatanakul, MSc;
Nartlada Chantharojwong, MSc;
Mary Culnane, MS,CRNP;
Jordan W. Tappero, MD,MPH;
Siripon Kanshana, MD,MPH
JAMA. 2002;288:245-248.
Context Each year in Thailand, about 10 000 children are born at risk for mother-to-child human immunodeficiency virus (HIV) transmission. In 2000, Thailand implemented a national program to prevent mother-to-child HIV transmission.
Objective To describe the results of implementation of the program.
Design Monthly collection of summary data from hospitals.
Setting Public health hospitals (n = 822) in all 12 regions of Thailand, representing 75 provinces, excluding Bangkok.
Participants Women giving birth from October 2000 through September 2001, including HIV-seropositive women and their neonates.
Main Outcome Measures Percentages of women giving birth who were tested for HIV, HIV-seropositive women giving birth who received antenatal prophylactic antiretroviral drugs, and HIV-exposed neonates who received prophylactic antiretroviral drugs and infant formula.
Results Among 573 655 women (range, 27 344-77 806 by region) giving birth, 554 912 (96.7%) received antenatal care (range, 91.9%-98.8% by region). Of 554 912 women giving birth who had antenatal care, 517 488 (93.3%) were tested for HIV (range, 87.7%-99.4% by region) before giving birth; of 18 743 women giving birth who did not have antenatal care, 13 314 (71.0%) were tested for HIV (range, 21.7%-92.9% by region). Of 6646 HIV-seropositive women giving birth, 4659 (70.1%) received prophylactic antiretroviral drugs before delivery (range, 55.3%-81.2% by region). Of 6475 neonates of HIV-seropositive women, 5741 (88.7%) received prophylactic antiretroviral drugs (range, 67.4%-96.9% by region) and 5386 (83.2%) received infant formula (range, 65.3%-100% by region).
Conclusions Major program components of Thailand's national program for preventing mother-to-child HIV transmission were implemented. Thailand's experience may encourage other developing countries to implement or expand similar national programs.
Author Affiliations: Department of Health, Ministry of Public Health, Nonthaburi, Thailand (Drs Kanshana and Amornwichet); The Thailand Ministry of Public Health–US Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand (Drs Teeraratkul and Tappero, and Mss Naiwatanakul, Chantharojwong, and Culnane); Global AIDS Program, National Center for HIV, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Ga (Drs Simonds and Tappero and Ms Culnane).
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