Abrams Elaine J, Myer Landon, Rosenfield Allan, El-Sadr Wafaa M
International Center for HIV/AIDS Care and Treatment Programs, Mailman School of Public Health, Columbia University, New York, NY 10032, USA.
Am J Obstet Gynecol. 2007 Sep;197(3 Suppl):S101-6. doi: 10.1016/j.ajog.2007.03.068.
In many developing countries, services to prevent the mother-to-child transmission (PMTCT) of human immunodeficiency virus (HIV) operate with limited contact with HIV care and treatment programs, despite significant advances in the accessibility of both services. There is a need to deliver more complex multidrug PMTCT interventions that extend beyond single-dose nevirapine, particularly for pregnant women with advanced HIV disease who are at high risk of transmitting HIV to their children and require rapid initiation of life-long highly active antiretroviral therapy. We argue for strengthened ties between PMTCT services and HIV care and treatment programs in resource-limited settings, viewing PMTCT programs as a gateway to family-based HIV care and treatment. Existing experiences from the multicountry MTCT-Plus Initiative suggest that close ties between PMTCT services and HIV care and treatment programs are feasible and can lead to significant advances in reducing the vertical transmission of HIV and promoting the health of HIV-infected women, children, and families.
在许多发展中国家，尽管预防人类免疫缺陷病毒（HIV）母婴传播（PMTCT）服务和HIV护理及治疗项目在可及性方面均取得了显著进展，但二者之间的联系依然有限。有必要提供更为复杂的多药PMTCT干预措施，而非仅局限于单剂量奈韦拉平，特别是对于那些HIV病情严重、将HIV传播给子女风险高且需要迅速启动终身高效抗逆转录病毒治疗的孕妇。我们主张在资源有限的环境中加强PMTCT服务与HIV护理及治疗项目之间的联系，将PMTCT项目视为基于家庭的HIV护理及治疗的切入点。多国MTCT-Plus倡议的现有经验表明，PMTCT服务与HIV护理及治疗项目之间建立紧密联系是可行的，并且能够在减少HIV垂直传播以及促进HIV感染妇女、儿童和家庭的健康方面取得重大进展。
