title: An assessment of mother-to-child HIV transmission prevention in 16 pilot antenatal clinics in Jamaica.
abstract: OBJECTIVE
  This study aims to determine the number and age distribution of pregnant women testing positive for HIV at 16 selected clinics in Jamaica between 2001 and 2002; the utilization of therapeutic interventions to minimize the risk of mother-to-child transmission (MTCT) and the current status of the HIV-exposed infants and, finally, the number of children who received testing for detection of HIV and to calculate the incidence of MTCT in these children.
  
  
  METHODS
  A retrospective study was carried out at sixteen pilot clinic sites by examining the patient records for all confirmed HIV-positive pregnant mothers and the resultant infants at these facilities for the period January 2001 to December 2002.
  
  
  RESULTS
  One hundred and twenty-three of 8116 pregnant women newly tested positive during the period January 2001 to December 2002; however, 176 HIV+ women delivered. Fifty-three (30%) knew their HIV status prior to participating in the programme. Sixty-two (1.4%) and 61 (1.6%) tested positive in 2001 and 2002, respectively. One hundred and ten (77%) and 113 (83%) mothers and infants, respectively, received ARV therapy, (92% - nevirapine, 8% - zidovudine). Twenty-three per cent of pregnant women received no ARV Forty-four (25.0%) of the 176 infants had a documented ELISA HIV test before eighteen months of age, none had a PCR test. The health status of 40 (23%) of these children was known: 30 (75%) were alive and well, five of whom did not receive any ARV, one (2.5%) was alive and ill and nine (22.5%) were reported dead, five of whom received ARV; 28.6% of infants who did not receive ARV were reported as either dead or ill compared to 13.8% of those receiving ARV CONCLUSION: Though the majority of pregnant women discovered their HIV status during pregnancy, a significant number got pregnant knowing that they were HIV+. The majority of mothers and infants received ARV but the follow-up and testing of infants was limited. Nevirapine is clearly protective in the prevention of MTCT of HIV and should be made universally accessible. All infants delivered to HIV+ mothers should be identified and tested for HIV.
authors.affiliation: The National HIV/AIDS Prevention and Control Programme, Ministry of Health, Kingston, Jamaica. harveyk@moh.gov.jm
authors.forename: K M
authors.initials: KM
authors.lastname: Harvey
authors.forename: J P
authors.initials: JP
authors.lastname: Figueroa
authors.forename: J
authors.initials: J
authors.lastname: Tomlinson
authors.forename: Y
authors.initials: Y
authors.lastname: Gebre
authors.forename: S
authors.initials: S
authors.lastname: Forbes
authors.forename: T
authors.initials: T
authors.lastname: Toyloy
authors.forename: T
authors.initials: T
authors.lastname: Thompson
authors.forename: K
authors.initials: K
authors.lastname: Thompson
mesh_terms: D015492:AIDS Serodiagnosis; D000554:Ambulatory Care Facilities; D002755:Choice Behavior; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control*; D006801:Humans; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D007563:Jamaica; D018743:Perinatal Care; D010865:Pilot Projects; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control*; D011295:Prenatal Care; D015995:Prevalence; D015397:Program Evaluation; D012189:Retrospective Studies; D018570:Risk Assessment