Studying PPTCT Services, Interventions, Coverage and Utilization in India

BACKGROUND AND OBJECTIVES: Risk of vertical transmission (largest source of HIV in children) reduces from 33% to 3% with effective PPTCT interventions. NACP III has got an objective of testing all pregnant women for earliest linkage with PMTCT. Study was carried out to find out PPTCT service coverage, drop-outs, interventions efficacy with other determinants. MATERIALS AND METHODS: At ICTCs, registered ANCs are counseled and tested for HIV. HIV+ve ANCs are linked to services and followed-up for institutional delivery, sdNVP, nutrition and children testing. HIV+ve ANCs since 2004 subsequently delivered till December 2009 and their exposed children in PPTCT-VSGH constituted study cohort. RESULTS: 29281 ANCs registered, 69.7% were counseled pre-test, 100% of them tested, 94.9% were counseled post-test. 60.5% were detected in 3(rd) trimester. CD4 testing was carried out in 71.6% HIV+ve ANCs. 81 ANCs were detected HIV+ve inclusive of 11 unregistered cases. 72 pregnancy outcomes reported institutionally, 77.6% were caesarian sections. Out of 59 live births, 56 sdNVP-MB-Pair were given. 88.1% children were traced till 18 months, 76.3% of live births were alive, 40.7% of live births were tested. 1 was found HIV+ve with history of adherence to all prescribed PPTCT guidelines. CONCLUSIONS: PMTCT services – counseling and testing should be provided to all ANCs. EDD-based tracking, institutional deliveries, postnatal counseling to be encouraged along with complete MB pair coverage, capacity building of concerned staff regarding delivery of HIV+ve ANCs and exposed children tracking.