Preventing mother-to-child transmission of HIV in resource-limited settings: the Elizabeth Glaser Pediatric AIDS Foundation experience.
OBJECTIVE
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.
Spensley
Allison
A
Elizabeth Glaser Pediatric AIDS Foundation, Santa Monica, CA, USA. allison@pedaids.org
Sripipatana
Tabitha
T
Turner
Abigail Norris
AN
Hoblitzelle
Chuck
C
Robinson
Joanna
J
Wilfert
Catherine
C
D019380:Anti-HIV Agents / Q000008:administration & dosage*; D003376:Counseling; D003906:Developing Countries; D005260:Female; D005582:Foundations; D015658:HIV Infections / Q000188:drug therapy* / Q000517:prevention & control* / Q000635:transmission; D006266:Health Education / Q000379:methods; D006801:Humans; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D019829:Nevirapine / Q000008:administration & dosage*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy; D011295:Prenatal Care / Q000379:methods*; D011322:Primary Prevention / Q000379:methods; D015397:Program Evaluation
D019380:Anti-HIV Agents; D019829:Nevirapine