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Preventing mother-to-child HIV transmission in low-income countries
May 06, 20082 articles discussing the prevention of HIV transmission from mother to child from PLoS Medicine
Can HIV transmission in pregnancy in low income settings be prevented with round the clock rapid testing in labor?
The World Health Organization has reported that over 500,000 children under 15 years of age become infected with HIV every year, mainly through mother-to-child transmission during pregnancy, childbirth, and breastfeeding (MTCT). Transmission around the time of birth can be prevented with antiretroviral drugs and safer delivery and feeding practices. However, in many low-income settings a woman may have few opportunities for HIV testing before she goes into labor. Therefore, programs in which immediate HIV testing is made available within the context of the labor ward, together with counseling and treatment services, may help to reduce the extent of MTCT in developing countries.
In this issue of PLoS Medicine, Nitika Pant Pai and colleagues evaluated such a program, carried out in a rural hospital in Maharashtra State, India. The researchers found that most women presenting in labor did not already know their HIV status, but the overwhelming majority accepted HIV testing on the labor ward. As part of the program, women were enrolled, received counseling, their test results, and referral for treatment interventions (if appropriate) within 40-60 minutes. As a result of the program, 15 women (of 1,222 in total who received HIV testing) were found to be HIV infected, of whom 11 were newly diagnosed at the point of care. These results demonstrate the feasibility of introducing rapid, round-the-clock HIV testing within a labor ward in a low-income setting.
Future challenges involve establishing how these findings can be applied more widely in other low-income settings to upgrade and expand existing HIV testing services.
In an expert commentary on the new research, David Celentano (Bloomberg School of Public Health, Johns Hopkins University), who was not involved in the study, says: "It is clear that the labor and delivery setting offers the final opportunity to detect and prevent mother-to-child transmission of HIV. The program outlined by Pai and colleagues is efficient, acceptable, and leads to reduced morbidity."
http://medicine.plosjournals.org/perlserv/?request=get-document&doi=10.1371/journal.pmed.0050092
Public Library of Science
In this issue of PLoS Medicine, Nitika Pant Pai and colleagues evaluated such a program, carried out in a rural hospital in Maharashtra State, India. The researchers found that most women presenting in labor did not already know their HIV status, but the overwhelming majority accepted HIV testing on the labor ward. As part of the program, women were enrolled, received counseling, their test results, and referral for treatment interventions (if appropriate) within 40-60 minutes. As a result of the program, 15 women (of 1,222 in total who received HIV testing) were found to be HIV infected, of whom 11 were newly diagnosed at the point of care. These results demonstrate the feasibility of introducing rapid, round-the-clock HIV testing within a labor ward in a low-income setting.
Future challenges involve establishing how these findings can be applied more widely in other low-income settings to upgrade and expand existing HIV testing services.
In an expert commentary on the new research, David Celentano (Bloomberg School of Public Health, Johns Hopkins University), who was not involved in the study, says: "It is clear that the labor and delivery setting offers the final opportunity to detect and prevent mother-to-child transmission of HIV. The program outlined by Pai and colleagues is efficient, acceptable, and leads to reduced morbidity."
http://medicine.plosjournals.org/perlserv/?request=get-document&doi=10.1371/journal.pmed.0050092
Public Library of Science
HIV Transmission Current Events and HIV Transmission News RSSAIDS research reveals a lack of family-planning programs in Uganda
University of Alberta graduate student Jennifer Heys wants to make her message clear: there needs to be more education in Ugandan communities about contraception.
HIV uses several strategies to escape immune pressure
A study of how HIV mutates in response to immune system pressure by Emory Vaccine Center researchers shows that the virus can take several escape routes, not one preferred route.
Weighing costs, benefits of HIV treatments
Prevention versus treatment? Cost versus efficacy? So go two of the dilemmas looming over Dartmouth's Paul E. Palumbo, M.D., and his fellow researchers in the race to fight HIV and other infectious diseases in the developing world - especially among women and their young children.
An HIV-blocking gel for women
University of Utah scientists developed a new kind of "molecular condom" to protect women from AIDS in Africa and other impoverished areas. Before sex, women would insert a vaginal gel that turns semisolid in the presence of semen, trapping AIDS virus particles in a microscopic mesh so they can't infect vaginal cells.
Pre-chewed food could transmit HIV
Researchers have uncovered the first cases in which HIV almost certainly was transmitted from mothers or other caregivers to children through pre-chewed food.
New lab test offers better prediction of HIV microbicide safety
Scientists at Albert Einstein College of Medicine of Yeshiva University have devised a laboratory test for predicting whether microbicides against HIV are safe for human use.
New contraceptive device is designed to prevent sexual transmission of HIV
Researchers from Weill Cornell Medical College have published results showing that a new contraceptive device may also effectively block the transmission of the HIV virus.
Herpes medication does not reduce risk of HIV transmission
A recently completed international multi-center clinical trial has found that acyclovir, a drug widely used as a safe and effective treatment to suppress herpes simplex virus-2 (HSV-2), which is the most common cause of genital herpes, does not reduce the risk of HIV transmission when taken by people infected with both HIV and HSV-2.
Adult circumcision reduces risk of HIV transmission without reducing sexual pleasure
Two studies presented at the 104th Annual Scientific Meeting of the American Urological Association (AUA) show that adult circumcision reduces the risk of contracting the human immunodeficiency virus (HIV) and the risk of coital injury¬¬--without reducing pleasure or causing sexual dysfunction.
South African policy on adolescents' rights to access condoms is causing confusion
In 2007, South Africa's new Children's Act came into effect, granting children 12 years and older a host of rights relating to reproductive health, including the right to access condoms.
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