Implementing short-course zidovudine to reduce mother-infant HIV transmission in a large pilot program in Thailand

AIDS. 2000 Jul 28;14(11):1617-23. doi: 10.1097/00002030-200007280-00018.

Abstract

Objectives: To describe a pilot mother-infant HIV prevention program started by the Ministry of Public Health of Thailand in July 1998 and to report on the first year of its implementation.

Design: Analysis of monthly summaries of data from project logbooks, simple data forms in antenatal clinics and delivery rooms, site visits and workshops, mail survey.

Setting: All 89 public hospitals in seven north-eastern provinces of Thailand.

Participants: Childbearing women, program officials.

Interventions: Counseling and HIV testing for pregnant women, short-course antenatal zidovudine for HIV-infected pregnant women, and infant formula for their children.

Main outcome measures: Proportion of women with HIV test, proportion of HIV-infected women receiving zidovudine.

Results: Of 75,308 women who gave birth between July 1998 and June 1999, 74,511 (98.9%) had antenatal care, 51,492 (69.1%) in the same district and 23,019 (30.9%) outside the district where they gave birth. HIV test results were available at delivery for 46,648 (61.9%) women, 410 (0.9%) of whom tested positive. Of these HIV-infected women, 259 (63.2%) participated in the zidovudine program and 6 (1.5%) received zidovudine from other sources. The proportion of women whose HIV test results were known and proportion of HIV-infected women who received zidovudine increased significantly during the year.

Conclusions: A mother-infant HIV prevention program using short-course antenatal zidovudine was quickly implemented in a large region of Thailand with moderate HIV prevalence. This successful experience is leading to national implementation of a perinatal HIV prevention program in Thailand and may prompt other developing countries to start similar programs.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Anti-HIV Agents / pharmacology*
  • Female
  • HIV Infections / prevention & control*
  • HIV-1*
  • Health Plan Implementation
  • Humans
  • Infectious Disease Transmission, Vertical / prevention & control*
  • Male
  • Middle Aged
  • National Health Programs
  • Pilot Projects
  • Pregnancy
  • Pregnancy Complications, Infectious / prevention & control*
  • Reverse Transcriptase Inhibitors / pharmacology*
  • Surveys and Questionnaires
  • Thailand
  • Zidovudine / pharmacology*

Substances

  • Anti-HIV Agents
  • Reverse Transcriptase Inhibitors
  • Zidovudine