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Infectious Diseases in Obstetrics and Gynecology
Volume 2012 (2012), Article ID 543916, 9 pages
http://dx.doi.org/10.1155/2012/543916
Research Article

Progress towards Elimination of HIV Mother-to-Child Transmission in the Dominican Republic from 1999 to 2011

1Dirección General de Control de las Infecciones de Transmisión Sexual y SIDA (DIGECITSS), Ministerio de Salud Pública (MSP), Santo Domingo, Dominican Republic
2Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL 33199, USA
3Clinton Foundation Health Access Initiative, Santo Domingo, Dominican Republic
4United Nations Children's Fund (UNICEF), Santo Domingo, Dominican Republic
5Consejo Presidencial del SIDA (COPRESIDA), Santo Domingo, Dominican Republic
6Clínica de Familia La Romana, La Romana, Dominican Republic
7USAID/PEPFAR-Family Health International (FHI), Santo Domingo, Dominican Republic
8School of Medicine, Department of Medicine, New York University (NYU), New York, NY 10012, USA
9Centro Nacional de Investigaciones en Salud Materno Infantil Dr. Hugo Mendoza (CENISMI), Santo Domingo, Dominican Republic
10Hospital Infantil Robert Reid Cabral, Santo Domingo, Dominican Republic
11Hospital Materno Infantil San Lorenzo de los Mina, Santo Domingo, Dominican Republic
12Hospital Francisco Gonzalvo, La Romana, Dominican Republic
13Hospital Regional Universitario José María Cabral y Báez, Santiago de los Caballeros, Dominican Republic
14Children's Hospital of Philadelphia, Residency Program in Pediatrics, Philadelphia, PA 19104, USA
15Mailman School of Public Health, Columbia University, New York City, NY 10032, USA
16Columbia University International Family AIDS Program, La Romana, Dominican Republic

Received 6 July 2012; Accepted 16 September 2012

Academic Editor: Carmen Zorrilla

Copyright © 2012 Osvaldo Lorenzo et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

In 1999, prevention of mother-to-child transmission (pMTCT) using antiretrovirals was introduced in the Dominican Republic (DR). Highly active antiretroviral therapy (HAART) was introduced for immunosuppressed persons in 2004 and for pMTCT in 2008. To assess progress towards MTCT elimination, data from requisitions for HIV nucleic acid amplification tests for diagnosis of HIV infection in perinatally exposed infants born in the DR from 1999 to 2011 were analyzed. The MTCT rate was 142/1,274 (11.1%) in 1999–2008 and 12/302 (4.0%) in 2009–2011 ( ), with a rate of 154/1,576 (9.8%) for both periods combined. This decline was associated with significant increases in the proportions of women who received prenatal HAART (from 12.3% to 67.9%) and infants who received exclusive formula feeding (from 76.3% to 86.1%) and declines in proportions of women who received no prenatal antiretrovirals (from 31.9% to 12.2%) or received only single-dose nevirapine (from 39.5% to 19.5%). In 2007, over 95% of DR pregnant women received prenatal care, HIV testing, and professionally attended delivery. However, only 58% of women in underserved sugarcane plantation communities (2007) and 76% in HIV sentinel surveillance hospitals (2003–2005) received their HIV test results. HIV-MTCT elimination is feasible but persistent lack of access to critical pMTCT measures must be addressed.