Integrating Prevention of Mother-To-Child HIV Transmission Into Routine Antenatal Care: The Key to Program Expansion in Cameroon

J Acquir Immune Defic Syndr. 2005 Dec 1;40(4):486-93. doi: 10.1097/01.qai.0000163196.36199.89.

Abstract

With funds from Elizabeth Glaser Pediatric AIDS Foundation, the Cameroon Baptist Convention Health Board implemented a program to prevent mother-to-child transmission of HIV-1 (PMTCT) as part of its routine antenatal care, with single-dose maternal and infant peripartum nevirapine (NVP) prophylaxis of HIV-positive mothers and their babies. Nurses, midwives, nurse aides, and trained birth attendants counseled pregnant women, obtained risk factor data, and offered free HIV testing with same-day results. From February 2000 through December 2004, this program rapidly expanded to 115 facilities in 6 of Cameroon's 10 provinces, not only to large hospitals but to remote health centers staffed by trained birth attendants. We trained 690 health workers in PMTCT and counseled 68,635 women, 91.9% of whom accepted HIV testing. Of 63,094 women tested, 8.7% were HIV-1-positive. Independent risk factors for HIV-1 infection included young age at first sexual intercourse, multiple sex partners, and positive syphilis serology (P < 0.001 for each). We counseled 98.7% of positive and negative mothers on a posttest basis. Of 5550 HIV-positive mothers, we counseled 5433 (97.9%) on single-dose NVP prophylaxis. Consistent training and programmatic support contributed to rapid upscaling and high uptake and counseling rates.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Anti-HIV Agents / administration & dosage
  • Anti-HIV Agents / therapeutic use
  • Cameroon
  • Counseling
  • Female
  • HIV Infections / diagnosis
  • HIV Infections / prevention & control*
  • HIV Infections / transmission*
  • Humans
  • Infant, Newborn
  • Infectious Disease Transmission, Vertical / prevention & control*
  • Nevirapine / administration & dosage
  • Nevirapine / therapeutic use
  • Patient Education as Topic
  • Pregnancy
  • Pregnancy Complications, Infectious*
  • Prenatal Care / methods*
  • Reverse Transcriptase Inhibitors / administration & dosage
  • Reverse Transcriptase Inhibitors / therapeutic use
  • Risk Factors
  • Sexual Behavior
  • Syphilis

Substances

  • Anti-HIV Agents
  • Reverse Transcriptase Inhibitors
  • Nevirapine