Situation analisys on HIV vertical transmission

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Situation analisys on HIV vertical transmission

• Dr Zhanna Trumova
• Republican HIV/AIDS center
• The Republic of Kazakhstan

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Number of HIV-infected people detected in
Kazakhstan (per year)
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Spread of HIV/AIDS in Kazakstan (as of 01.09.03)
59 ??.
705 ??.
58 ??.
196 ??.
56??.
137 c?.
110 ??.
12 ??.
73 ??.
1210 ??.
38 ??.
7 ??.
19 ??.
62 ??.
185??.
368 ??.
3788 HIV-cases are registered in Kazakhstan
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Ways and factors of HIV transmission
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Prevalence of HIV - infected women by age groups
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Growth rates of HIV-positive women
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Number of pregnant women tested for HIV (per year)
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Number of detected HIV-infected pregnant women
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Prevalence of HIV-infected pregnant women by
region
Total - 205
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Risk factors for HIV-infected pregnant women
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Co-factors for HIV-infected pregnant women
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Pregnancy outcomes
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Spread of children by regionn75
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Health status of children born to HIV-infected
mothers
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Antiretroviral therapy of newborn, begun in 2002
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Feeding of newborn , n81
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Proposed preventive treatment schemes

• Scheme 1 ZDV (Protocol 076 from 14th week of
  pregnancy to delivery (II and III trimesters of
  pregnancy) 600 mg/pd from the beginning of
  labour to delivery 2 mg/kg, then 1 mg/kg
  intravenous per hour to the child suspension
  ZDV 2 mg/kg every 6 hours in the course of 6
  weeks)
• Scheme 2 short-term treatment ZDV from 36th
  week
• Scheme 3 Nevirapin the pregnant 200 mg once
  in delivery, the child nevirapin suspension 2
  mg/kg once within 72 hours (HIVNET 012, Uganda)

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Current activities

• A Government Dicree 1207 Programme on AIDS
  prevention in Kazakhstan from 2001 till 2005
  dated from 14 september 2001 was developed and
  aproved in Kazakhstan.
• Preventive Programmes aare being intriduced with
  the assistance of international organizations.
• Access to counselling and HIV voluntary testing
  
• Pregnant women and children are provided with
  antiviral medicine and child nutrition free of
  charge from public funds
• Quality medical care and preventive interventions
  are provided to HIV- infected women during
  pregnancy and deliveries

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Challenges

• Lack of information and educational materials on
  HIV and pregnancy
• Difficulties related to timely detection,
  registration, examination of people from
  risk-groups (drug addicts, RKS, etc) including
  pregnant women
• Weak VCT services network in health care,
  including PHC, obs -genecologi , in particular
  lack of professional training for health workers
  in HIV/AIDS consultation
• Lack of financing for equipment, test-systems,
  antiviral medications

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Possible solutions

• Primary prevention among pregnant women, access
  to HIV/AIDS info, promotion of safe sex,
  prevetion of unwanted pregnancy, availability of
  contraceptives, STIs treatment
• Introduction of voluntary consultation and
  testing for target-groups (IDU, CSW, married
  couples, youth) as a supplement to ongoing
  prevention programmes
• Prevention of mother-to-child HIV transmisstion
  in antenatal, intranatal and postnatal periods
• Access to antiretroviral medications
• Artificial feeding
• Care and support of HIV-infected women, their
  children and family members