Elimination of Mother-To-Child Transmission of HIV Infection: The Drug Resource Enhancement against AIDS and Malnutrition Model

Giuseppe Liotta, Maria Cristina Marazzi, Khethimipilo E. Mothibi, Ines Zimba, Evelyne E. Amangoua, Esther K. Bonje, Bernard N. B. Bossiky, Precious A. Robinson, Paola Scarcella, Kebby Musokotwane, Leonardo Palombi, Paola Germano, Pasquale Narciso, Andrea De Luca, Elard Alumando, Sangare H. Mamary, Nurja A. Magid, Giovanni Guidotti, Sandro Mancinelli, Stefano Orlando, Marco Peroni, Ersilia Buonomo and Karin Nielsen-Saines
Additional contact information
Giuseppe Liotta: University of Tor Vergata, 18-00173 Rome, Italy
Maria Cristina Marazzi: LUMSA University, 18-00173 Rome, Italy
Khethimipilo E. Mothibi: Health Services Cluster, Cité du Djoué, P.O. Box 06 Brazzaville, South Africa
Ines Zimba: Community of S.Egidio—DREAM program, Avenida de Julho 7, Maputo, Mozambique
Evelyne E. Amangoua: Ministère de la Santé et de la lutte contre le SIDA, B.P. 2091, Abidjan, Ivory Coast
Esther K. Bonje: Cameroon Baptist Convention Health Services, P.O. Box 1 Bamenda, Cameroon
Bernard N. B. Bossiky: Programme National Multisectoriel de Lutte contre le Sida, Blvd Triomphal and 24 Novembre Kinshasa, Congo (RDC)
Precious A. Robinson: National Department of Health, Private Bag X9070, South Africa
Paola Scarcella: University of Tor Vergata, 18-00173 Rome, Italy
Kebby Musokotwane: Ministry of Health, Ndeke House, P.O. Box 30205, Lusaka, Zambia
Leonardo Palombi: University of Tor Vergata, 18-00173 Rome, Italy
Paola Germano: INMI L. Spallanzani, 00149 Rome, Italy
Pasquale Narciso: INMI L. Spallanzani, 00149 Rome, Italy
Andrea De Luca: Division of Infectious Diseases, Department of Medical Biotechnologies, University of Siena, Siena University Hospital, Siena 53100, Italy
Elard Alumando: Community of S.Egidio—DREAM program, P.O. Box 30355, Blantyre, Malawi
Sangare H. Mamary: Community of S.Egidio—DREAM program, P.O. Box 30355, Blantyre, Malawi
Nurja A. Magid: Community of S.Egidio—DREAM program, Avenida de Julho 7, Maputo, Mozambique
Giovanni Guidotti: Community of S.Egidio—DREAM program, Rome 00153, Italy
Sandro Mancinelli: University of Tor Vergata, 18-00173 Rome, Italy
Stefano Orlando: Community of S.Egidio—DREAM program, Rome 00153, Italy
Marco Peroni: Community of S.Egidio—DREAM program, Rome 00153, Italy
Ersilia Buonomo: University of Tor Vergata, 18-00173 Rome, Italy
Karin Nielsen-Saines: David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA 90095, USA

IJERPH, 2015, vol. 12, issue 10, 1-16

Abstract: The Drug Resource Enhancement against AIDS and Malnutrition Program (DREAM) gathered professionals in the field of Elimination of HIV-Mother-To-Child Transmission (EMTCT) in Maputo in 2013 to discuss obstacles and solutions for the elimination of HIV vertical transmission in sub-Saharan Africa. During this workshop, the benefits of administrating combined antiretroviral therapy (cART) to HIV positive women from pregnancy throughout breastfeeding were reviewed. cART is capable of reducing vertical transmission to less than 5% at 24 months of age, as well as maternal mortality and infant mortality in both HIV infected and exposed populations to levels similar to those of uninfected individuals. The challenge for programs targeting eMTCT in developing countries is retention in care and treatment adherence. Both are intrinsically related to the model of care. The drop-out from eMTCT programs before cART initiation ranges from 33%–88% while retention rates at 18–24 months are less than 50%. Comprehensive strategies including peer-to-peer education, social support and laboratory monitoring can reduce refusals to less than 5% and attain retention rates approaching 90%. Several components of the model of care for reduction of HIV-1 MTCT are feasible and implementable in scale-up strategies. A review of this model of care for HIV eMTCT is provided.

Keywords: elimination of HIV MTCT; DREAM program (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2015
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (1)

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