Shetty Avinash K, Marangwanda Caroline, Stranix-Chibanda Lynda, Chandisarewa Winfreda, Chirapa Elizabeth, Mahomva Agnes, Miller Anna, Simoyi Micah, Maldonado Yvonne
Department of Pediatrics, Wake Forest University Health Sciences, Winston-Salem, USA.
AIDS Res Ther. 2008 Aug 1;5:17. doi: 10.1186/1742-6405-5-17.
Prevention of mother-to-child transmission of HIV (PMTCT) is a major public health challenge in Zimbabwe.
Using trained peer counselors, a nevirapine (NVP)-based PMTCT program was implemented as part of routine care in urban antenatal clinics.
Between October 2002 and December 2004, a total of 19,279 women presented for antenatal care. Of these, 18,817 (98%) underwent pre-test counseling; 10,513 (56%) accepted HIV testing, of whom 1986 (19%) were HIV-infected. Overall, 9696 (92%) of women collected results and received individual post-test counseling. Only 288 men opted for HIV testing. Of the 1807 HIV-infected women who received posttest counseling, 1387 (77%) collected NVP tablet and 727 (40%) delivered at the clinics. Of the 1986 HIV-infected women, 691 (35%) received NVPsd at onset of labor, and 615 (31%) infants received NVPsd. Of the 727 HIV-infected women who delivered in the clinics, only 396 women returned to the clinic with their infants for the 6-week follow-up visit; of these mothers, 258 (59%) joined support groups and 234 (53%) opted for contraception. By the end of the study period, 209 (53%) of mother-infant pairs (n = 396) came to the clinic for at least 3 follow-up visits.
Despite considerable challenges and limited resources, it was feasible to implement a PMTCT program using peer counselors in urban clinics in Zimbabwe.
预防艾滋病毒母婴传播（PMTCT）是津巴布韦面临的一项重大公共卫生挑战。
利用经过培训的同伴咨询员，在城市产前诊所将基于奈韦拉平（NVP）的预防艾滋病毒母婴传播项目作为常规护理的一部分实施。
在2002年10月至2004年12月期间，共有19279名妇女前来接受产前护理。其中，18817名（98%）接受了检测前咨询；10513名（56%）接受了艾滋病毒检测，其中1986名（19%）感染了艾滋病毒。总体而言，9696名（92%）妇女领取了检测结果并接受了个体化检测后咨询。只有288名男性选择接受艾滋病毒检测。在1807名接受检测后咨询的感染艾滋病毒的妇女中，1387名（77%）领取了奈韦拉平片剂，727名（40%）在诊所分娩。在1986名感染艾滋病毒的妇女中，691名（35%）在临产前接受了奈韦拉平单剂量方案，615名（31%）婴儿接受了奈韦拉平单剂量方案。在727名在诊所分娩的感染艾滋病毒的妇女中，只有396名妇女带着婴儿回到诊所进行为期6周的随访；在这些母亲中，258名（59%）加入了支持小组，234名（53%）选择了避孕措施。到研究期结束时，396对母婴中的209对（53%）来到诊所进行了至少3次随访。
尽管面临诸多挑战且资源有限，但在津巴布韦城市诊所利用同伴咨询员实施预防艾滋病毒母婴传播项目是可行的。
