Performance of the prevention of parent to child transmission program: A decadal trend from rural Maharashtra, India

Abstract

Background:Human immunodeficiency virus (HIV) infection is widely spread across the state of Maharashtra with high prevalence among antenatal women.Aims:To assess the effectiveness of prevention of parent to child transmission (PPTCT) services in rural Tertiary Health Care Centre of Western Maharashtra, India and to address the weaknesses in functioning of PPTCT services.Materials and Methods:A cross-sectional study was conducted at Integrated Counselling and Testing Centre (ICTC) of a rural tertiary health center located in rural area of Western Maharashtra over a period of 10 years from 2003 to 2012. A total of 32,575 pregnant women were included as study subjects and data were collected as per the indicators of PPTCT by viewing the retrospective PPTCT records. The data were analyzed over the period of 10 years for the outcome of PPTCT services. The trend of PPTCT indicators over a decade were analyzed by using Chi-square test.Results:The seroprevalence of HIV infection among pregnant women was 2% in 2003 which decreased to 0.2% by 2012. The proportions of women counseled and HIV tested were 88.9% and 100%, respectively in 2003 and pretest counseling trend was steadily increased to 100% by 2012; however; HIV testing trend remained 100% throughout 10 years. Posttest counseling trend ranges from 89.6% to 99.9% whereas trend of HIV testing among partners has been fluctuating from 25% to 100%. The proportional trend of HIV-positive mothers delivered in a tertiary care hospital ranges from 60% to 100%. The proportions of pair receiving prophylaxis Nevirapine has been increased from 83.8% to 100% by 2009, but thereafter decreased to 83.3% by 2012. The overall HIV positivity among babies after 18 months of follow-up was 21%.Conclusion:HIV seroprevalence among the pregnant population is steadily declining. More and more women are availing the facilities of ICTC centers. Intensive health education and availability of diagnostic and therapeutic services in rural health center have reduced the burden of HIV/AIDS problem in the rural community.

HIV in pregnancy: a 9 year study of the seroprevalence, sociodemographic factors and pregnancy outcomes of seropositive women at a tertiary care hospital in Mumbai, Maharashtra, India

“…[6][7][8] As seen in our study, Mohite et al, also reported an increase in the acceptance rate of pretest counseling and HIV testing, from 88.9% to 100% over 10 years. 9 The seroprevalence rate in our study was low compared to other studies, as shown in Table 4.…”

“…6,15 Mohite et al reported a partner testing rate of 54.9%, with an increasing trend of acceptance over the years, as stated in our study. 9 In our study 50.88% of the antenatal seropositive mothers were primigravidas, with majority being housewives from low income classes, with a very poor educational background. Most of the women themselves denied any addictions but 81.29% revealed that husbands had addictions to alcohol/tobacco/illicit drugs.…”

“…Mohite et al, reported a decline from 2% in 2003 to 0.2% in 2012. 9 71.93% of partners of the HIV positive antenatal women underwent HIV testing in our study, and 56.91% of those tested were HIV positive. In studies done by Shiradkar et al,and Dadhwal et al,76.95% and 80% partners tested positive respectively.…”

Efficacy and safety of a single‐tablet regimen containing tenofovir disoproxil fumarate 300 mg, lamivudine 300 mg and efavirenz 400 mg as a switch strategy in virologically suppressed HIV‐1‐infected subjects on nonnucleoside reverse transcriptase inhibitor‐containing first‐line antiretroviral therapy in Pune, India

“…India has 2.1 million PWH, with 88 000 people becoming newly infected annually [5,6]. Pune is located in the state of Maharashtra, which has the highest estimated number of PWH [0.33 million; interquartile range (IQR) 0.25-0.43 million] in India [7][8][9].…”

Prevalence of HIV infection in pregnant women in Mumbai, India: Experience from 1993-2004 and 2008

“…[ 2 3 ] Thus, estimating prevalence of HIV in pregnant women would aid in developing and prioritizing prevention of parent–to-child transmission of HIV (PPTCT) programs. Although various studies have commented on prevalence of HIV in pregnant women in various areas of India and Maharashtra which ranged from 1.11%–2% in 2002–2003 and have now decreased to 0.37%–0.2% by 2011–2012,[ 4 5 ] there are very limited data from Mumbai, a city situated in Western India and in the State of Maharashtra, which has the highest number of adults living with HIV in the country (3.01 lakhs). [ 2 ] Thus, changes in prevalence rates over a period of years cannot be derived from them.…”