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;288:245-248.

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.