Five-year trends in epidemiology and prevention of mother-to-child HIV transmission, St. Petersburg, Russia: results from perinatal HIV surveillance

Details

• Alternative Title:
  BMC Infect Dis
• Personal Author:
  Kissin, Dmitry M. ; Mandel, Michele G. ; Akatova, Natalia ; Belyakov, Nikolay A. ; Rakhmanova, Aza G. ; Voronin, Evgeny E. ; Volkova, Galina V. ; Yakovlev, Alexey A. ; Jamieson, Denise J. ; Vitek, Charles ; Robinson, Joanna ; Miller, William C. ; Hillis, Susan
• Description:
  Background
  
  The HIV epidemic in Russia has increasingly involved reproductive-aged women, which may increase perinatal HIV transmission.
  
  Methods
  
  Standard HIV case-reporting and enhanced perinatal HIV surveillance systems were used for prospective assessment of HIV-infected women giving birth in St. Petersburg, Russia, during 2004-2008. Trends in social, perinatal, and clinical factors influencing mother-to-child HIV transmission stratified by history of injection drug use, and rates of perinatal HIV transmission were assessed using two-sided χ2 or Cochran-Armitage tests.
  
  Results
  
  Among HIV-infected women who gave birth, the proportion of women who self-reported ever using injection drugs (IDUs) decreased from 62% in 2004 to 41% in 2008 (P < 0.0001). Programmatic improvements led to increased uptake of the following clinical services from 2004 to 2008 (all P < 0.01): initiation of antiretroviral prophylaxis at ≤28 weeks gestation (IDUs 44%-54%, non-IDUs 45%-72%), monitoring of immunologic (IDUs 48%-64%, non-IDUs 58%-80%) and virologic status (IDUs 8%-58%, non-IDUs 10%-75%), dual/triple antiretroviral prophylaxis (IDUs 9%-44%, non-IDUs 14%-59%). After initial increase from 5.3% (95% confidence interval [CI] 3.5%-7.8%) in 2004 to 8.5% (CI 6.1%-11.7%) in 2005 (P < 0.05), perinatal HIV transmission decreased to 5.3% (CI 3.4%-8.3%) in 2006, and 3.2% (CI 1.7%-5.8%) in 2007 (P for trend <0.05). However, the proportion of women without prenatal care and without HIV testing before labor and delivery remained unchanged.
  
  Conclusions
  
  Reduced proportion of IDUs and improved clinical services among HIV-infected women giving birth were accompanied by decreased perinatal HIV transmission, which can be further reduced by increasing outreach and HIV testing of women before and during pregnancy.
  
  
• Subjects:
  Adult Female HIV Infections Humans Incidence Infant, Newborn Infectious Disease Transmission, Vertical Models, Statistical Pregnancy Prospective Studies Risk Factors

  More +
• Source:
  BMC Infect Dis. 2011; 11:292.
• Document Type:
  Journal Article
• Place as Subject:
  Russia
• Volume:
  11
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:31b929618229de36f42759d29cd955c537191d98f4ab48ab8a292ec9caf5c357
• Download URL:
  https://stacks.cdc.gov/view/cdc/3391/cdc_3391_DS1.pdf
• File Type:
  [PDF - 456.47 KB ]