Thailand reduces mother-to-child transmission of HIV

 

Mekong countries join hands in preventing HIV transmission to children

In Thailand, a programme to reduce mother-to-child transmission of HIV has helped in halving the number of young children infected in this way. Today Thailand is providing technical assistance to other countries in the Mekong region to help them achieve similar results.

In Thailand, concerted efforts to reduce the rate of mother-to-child transmission of HIV have helped in achieving a 50% reduction in the number of children under four infected with the virus.

Launched in 1997, the programme includes voluntary counselling and testing for women attending antenatal care, a short course of anti-retroviral drugs during pregnancy for women found to be HIV-positive, and subsidies for breast-milk substitutes for one year. By 1999, the number of children under four years old infected during pregnancy, at birth, or through breastfeeding had been halved -- from over 1200 in 1997 to 600 in 1999.

Mother-to-child transmission of HIV is today a high priority in East Asia, due to the rapid spread of HIV/AIDS, especially among women of reproductive age. In Thailand, where the government launched broad-based efforts to halt the spread of HIV, less than 2% of pregnant women are infected with HIV. In Myanmar, a study in early 1999 found that 2.6% of pregnant women were HIV-positive -- with as many as 10%-13% of women testing positive at some test sites.

Today, Thailand is sharing technical assistance and expertise with Myanmar, Cambodia, and other countries in an effort to reduce mother-to-child transmission of HIV throughout the region. Rapid and flexible tools for assessing HIV transmission to children have been developed.

Results from these assessments in various countries have underlined the critical importance of continuing primary prevention of HIV in women and men, and the need to strengthen community-based efforts to care for and support individuals and families affected by HIV/AIDS. The Thailand success story has also shown that these efforts must involve all levels and sectors of government as well as communities. With assistance from Thailand, a bold programme is being developed in Myanmar to halt mother-to-child transmission of HIV. The programme will include training health workers in prevention issues, encouraging voluntary counselling and confidential testing, supporting the use of anti-retroviral drugs, assisting mothers in making the best choices for infant feeding, promotion of birth spacing, and strengthening existing health care for mothers and infants. The programme will involve working in partnership with NGOs and community-based organizations to provide care and support for people affected by HIV/AIDS. All of these activities will take place within the overall framework of HIV/AIDS prevention nationwide.

In Myanmar, some of this work has already begun. A working group has developed voluntary-counselling training manuals for health care providers, NGOs, and community leaders. And by the end of 2000, 120 participants -- including health staff, NGO representatives, and community and religious leaders -- from the three pilot townships will have been trained in various aspects of preventing mother-to-child transmission of HIV.

The Thailand experience also highlighted the importance of complementing technical efforts for prevention of mother-to-child transmission of HIV with a social mobilization campaign. A social mobilization campaign has been launched in the pilot townships, which addresses the key role of families, communities, and religious leaders in building support for HIV prevention efforts. The campaign will focus on the need to encourage pregnant women to make better use of antenatal facilities, including services to prevent mother-to-child transmission of HIV, and to support mothers in making informed choices about infant feeding. Meanwhile, continuing efforts will also be needed to reduce the social stigma associated with HIV/AIDS and to provide assistance to people living with HIV.