title: Progress towards elimination of HIV mother-to-child transmission in the Dominican Republic from 1999 to 2011.
abstract: In 1999, prevention of mother-to-child transmission (pMTCT) using antiretrovirals was introduced in the Dominican Republic (DR). Highly active antiretroviral therapy (HAART) was introduced for immunosuppressed persons in 2004 and for pMTCT in 2008. To assess progress towards MTCT elimination, data from requisitions for HIV nucleic acid amplification tests for diagnosis of HIV infection in perinatally exposed infants born in the DR from 1999 to 2011 were analyzed. The MTCT rate was 142/1,274 (11.1%) in 1999-2008 and 12/302 (4.0%) in 2009-2011 (P < .001), with a rate of 154/1,576 (9.8%) for both periods combined. This decline was associated with significant increases in the proportions of women who received prenatal HAART (from 12.3% to 67.9%) and infants who received exclusive formula feeding (from 76.3% to 86.1%) and declines in proportions of women who received no prenatal antiretrovirals (from 31.9% to 12.2%) or received only single-dose nevirapine (from 39.5% to 19.5%). In 2007, over 95% of DR pregnant women received prenatal care, HIV testing, and professionally attended delivery. However, only 58% of women in underserved sugarcane plantation communities (2007) and 76% in HIV sentinel surveillance hospitals (2003-2005) received their HIV test results. HIV-MTCT elimination is feasible but persistent lack of access to critical pMTCT measures must be addressed.
authors.affiliation: Dirección General de Control de las Infecciones de Transmisión Sexual y SIDA (DIGECITSS), Ministerio de Salud Pública (MSP), Santo Domingo, Dominican Republic.
authors.forename: Osvaldo
authors.initials: O
authors.lastname: Lorenzo
authors.forename: Consuelo M
authors.initials: CM
authors.lastname: Beck-Sagué
authors.forename: Claudia
authors.initials: C
authors.lastname: Bautista-Soriano
authors.forename: Mina
authors.initials: M
authors.lastname: Halpern
authors.forename: José
authors.initials: J
authors.lastname: Roman-Poueriet
authors.forename: Nora
authors.initials: N
authors.lastname: Henderson
authors.forename: Eddy
authors.initials: E
authors.lastname: Perez-Then
authors.forename: Rosa
authors.initials: R
authors.lastname: Abreu-Perez
authors.forename: Solange
authors.initials: S
authors.lastname: Soto
authors.forename: Luis
authors.initials: L
authors.lastname: Martínez
authors.forename: Sarah
authors.initials: S
authors.lastname: Rives-Gray
authors.forename: Bienvenido
authors.initials: B
authors.lastname: Veras
authors.forename: Maureen
authors.initials: M
authors.lastname: Connolly
authors.forename: Greer Brittany
authors.initials: GB
authors.lastname: Callender
authors.forename: Stephen W
authors.initials: SW
authors.lastname: Nicholas
mesh_terms: D000293:Adolescent; D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active / Q000379:methods*; D001942:Breast Feeding / Q000009:adverse effects; D002675:Child, Preschool; D004293:Dominican Republic; D005260:Female; D006678:HIV / Q000302:isolation & purification; D015658:HIV Infections / Q000635:transmission*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007223:Infant; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000523:psychology; D011247:Pregnancy; D011295:Prenatal Care; D019562:Viral Load; D055815:Young Adult
chemical_list: D019380:Anti-HIV Agents