HIV infection and prevention of mother-to-child transmission in childbearing women: La Romana, Dominican Republic, 2002-2006 Infección por el VIH en parturientas y prevención de la transmisión madre-hijo en La Romana, República Dominicana, 2002-2006

• Main Authors: José Román-Poueriet, Aracelis D. Fernandez, Consuelo M. Beck-Sagué, René García Szabó, Fermin Mercedes, William Duke, Anny Martinez, Stephen Nicholas
• Format: Article in Journal/Newspaper
• Language: English; Spanish; Portuguese
• Published: Pan American Health Organization 2009
• Subjects: Infecciones por VIH; transmisión vertical de enfermedad infecciosa; República Dominicana; HIV infections; infectious disease transmission; vertical; Dominican Republic; Medicine; R; Arctic medicine. Tropical medicine; RC955-962; Public aspects of medicine; RA1-1270; Arctic
• Online Access: https://doaj.org/article/fafae2a8d08e462d867eee4c08177ef4

OBJECTIVES: To strengthen prevention of mother-to-child HIV transmission (pMTCT) program implementation in La Romana (LR) province, by estimating HIV prevalence and identifying characteristics associated with HIV infection in parturients. METHODS: Umbilical cord blood samples were collected at seven obstetrical sites where over 95% of LR's deliveries occur during four phases (pilot, expanded pilot, full study, and pMTCT program monitoring) from 2 August 2002 to 30 September 2006. Results were linked to data abstracted from delivery records. RESULTS: HIV seroprevalence was 2.6% (263/10 040 overall; 114/4 452, full-study phase (95% confidence interval = 2.1%-3.1%)). Most HIV-infected parturients were Dominican (68.9%) and urban (64.0%). However, prevalence was higher among Haitians (3.7%) than Dominicans (2.3% (p < 0.001)), especially those aged 21-25 years (5.2% vs. 2.3% (p < 0.001)), and among rural, batey, and peri-urban (vs. urban) parturients (3.4% vs. 2.3%, (p = 0.003)). HIV prevalence was associated with commercial sex work (reported by only 0.4%), and prior pregnancy. In logistic regression analysis, commercial sex work, Haitian nationality, and prior pregnancy were independently associated with HIV infection. Caesarean deliveries were more frequent, and rose in the last years of the study, among HIV seropositives; however, most deliveries among seropositives (57.5%) were vaginal. CONCLUSIONS: HIV prevalence among LR parturients was higher than the estimated prevalence in the Dominican Republic (0.8%-1.0%) and, in contrast to past studies, predominantly affected urban Dominicans. HIV prevalence among LR Haitian parturients was higher than among Dominican counterparts and prenatal clinic attendees in Haiti (who had a rate of 3.1%). Consistently implemented, targeted pMTCT interventions are needed. OBJETIVOS: Fortalecer el programa de prevención de la transmisión de la infección por el VIH madre-hijo (PPTIMH) en la provincia de La Romana (LR), mediante la estimación de la prevalencia y la ...