A Paradigm Shift in the Epidemiology of HIV in Pregnancy at ICTC of a Medical College.

Abstract

To study the present status and effect of paradigm shift in the epidemiology of HIV amongst pregnant women in urban set up. The purpose of the study is to evaluate the paradigm shift in overall screening and management strategy of HIV in antenatal women for last four and half years in an urban medical college. The study was conducted from 1st January 2004 to 30th June 2008 and all registered and unregistered pregnant women who attended ICTC clinic and also for emergency admission (unregistered) were counseled and blood samples were tested as per NACO guidelines with cafeteria choice of opt in and opt out strategy. Reactive women in antenatal period were counseled and discussed about anti-retroviral therapy (ART) and universal treatment regime. Seroprevalent women were counseled about their spouse, personal habits and demographic status. Marked improvement was seen in the use of contraceptive and drug abuse. During labor mother and baby were given nevirapine as per NACO guidelines. The seroprevalence of HIV reactive women in our Centre was 0.23, 0.19, 0.14 and 0.12% in the year 2004, 2005, 2006, 2007 and zero prevalence in 2008 till date. Spouse positivity was noted in 80, 58.33, 72.72 and 70% in the set period from 2004 to 2008. Marked improvement was noticed in all the strategic points from registration, counseling, screening and availability of improved diagnostic kits for screening HIV 1 and HIV 2.