Preventing mother-to-child HIV transmission - The first year of Thailand's national program

Context Each year in Thailand, about 10000 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, 27344-77806 by region) giving birth, 554 912 (96.7%) received antenatal care (range, 91.9%-98.8% by region). Of 554912 women giving birth who had antenatal care, 517488 (93.3%) were tested for HIV (range, 87.7%-99.4% by region) before giving birth; of 18743 women giving birth who did not have antenatal care, 13314 (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 antireiroviral, 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.