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Letter From Thailand |

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(2):245-248. doi:10.1001/jama.288.2.245.
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ABSTRACT

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.

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Figures

Figure 1. Levels of HIV Testing and Receipt of Antiretroviral (ARV) Drugs, by Antenatal Care Status
Graphic Jump Location
The data represent women giving birth in Thailand, October 2000-September 2001. Of women receiving antenatal care, those who are designated as not receiving antenatal treatment did not receive treatment during labor.
Figure 2. Levels of Testing for HIV in Women, by Antenatal Care Status
Graphic Jump Location
*Women giving birth in Thailand, October 2000-September 2001.
Figure 3. Percentage of HIV-Seropositive Women Giving Birth in Ministry of Public Health Hospitals Who Received Prophylactic Antiretroviral (ARV) Therapy, by Region, Thailand, October 2000 to September 2001
Graphic Jump Location
Figure 4. Levels of Receipt of Prophylactic Antiretroviral (ARV) Drugs by Women Giving Birth and Their Children
Graphic Jump Location
The data represent HIV-seropositive women and their children in Thailand, October 2000-September 2001.

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