Prevention of mother-to-child HIV transmission program in Iran

Parvin Afsar Kazeroni,Ebrahim Ghaderi,Mohammad Aziz Rasouli,Bushra Zareie,Mohammad Mehdi Gouya,Sana Eybpoosh,Mandana Tira,Zahra Majdfar,Maryam Sargolzaiie

doi:10.1186/s12889-021-10520-6

Abstract

BackgroundThe reproductive health and Prevention of Mother-to-Child Transmission (PMTCT) of HIV programs in Iran were integrated as a pilot project in September 2014. This study aims to provide a comprehensive evaluation and analysis of the PMTCT of HIV program in Iran.MethodsThe pilot phase of PMTCT of HIV was launched in early September 2014 in selected centers including 170 health centers and 40 hospitals affiliated to medical universities of 16 provinces of Iran. In each medical university, a researcher-made checklist was administered to all newly-diagnosed HIV-positive pregnant women by an AIDS expert. Data was analyzed using SPSS 19.ResultsOverall, 69.4% of eligible pregnant women were enrolled in the pilot phase. From 134 reactive cases, 76 (56.7%) were confirmed as HIV positive. ARV consumption was irregular in 10 (13.2%) of HIV positive pregnant women. Also, 82.5% had CD4 count more than 350 after treatment, with an average of 55.5% increase in the number of CD4 in comparison to the baseline, and 84.8% had viral load suppression (< 200 copies/ml). Counseling and testing was done for the husbands of 75% of the women that resulted in the identification of 15 (39.5%) new HIV cases among husbands. Among the tested individuals, 23 (60.5%) males already knew their HIV status and were registered as HIV patients. HIV was diagnosed in one (1.5%) newborn.ConclusionImplementation of rapid HIV testing and PMTCT in Iran is one of the strengths of the national HIV control program. To eliminate MTCT, it is necessary to understand and overcome the barriers and challenges to the program in the pilot phase.

Highlights

The reproductive health and Prevention of Mother-to-Child Transmission (PMTCT) of HIV programs in Iran were integrated as a pilot project in September 2014
The guidelines for general principles and national policies on linking HIV/AIDS control and reproductive health programs for pilot centers were prepared with the participation of Ministry of Health (MOH) offices for AIDS control and maternal health, which made it possible to carry out the planned activities of the program at the practical level
During the pilot phase of the program, a total number of 25,808 pregnant women were tested for HIV using rapid test kits, of which 134 cases were reported as reactive, and 76 (56.7%) cases were confirmed as HIV positive

Summary

Introduction

The reproductive health and Prevention of Mother-to-Child Transmission (PMTCT) of HIV programs in Iran were integrated as a pilot project in September 2014. Despite improvements in prevention of mother to child transmission (PMTCT) of HIV, in 2016 there were 160.000 new infections in children globally, most of which in low- and middle-income countries. Iran is a pioneer country in the evidence-based implementation of HIV control program in the Middle East region. The increase in the prevalence of infection in Iranian women in recent years [3] has raised the likelihood of an increase in mother-to-child transmission which highlights the need to reinforce preventive measures in this regard. According to the estimates of the Ministry of Health (MOH) in Iran, the number of newborn babies born to HIV-infected women will increase by 2020 and will reach about 470 newborns. There is a vital need for planning for this vulnerable stratum [4]

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