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APHA Scientific Session and Event Listing

Jason A. Turi, RN, BSN, MPH '07, Conor Shapiro, MPH '07, and Wesler Lambert, MD, MPH '07. Department of International Health, Boston University School of Public Health, 715 Albany Street, Boston, MA 02118, 973-951-8510, jturi@bu.edu

Prevention of mother-to-child transmission of HIV (PMTCT) in rural Haiti, where HIV seroprevalence of pregnant women is approximately 5-10 percent, challenges care providers to implement comprehensive and community-based services to curtail the AIDS epidemic in these impoverished communities. The Pan American Health Organization estimates that 30 percent of children born to HIV positive mothers in Haiti will be infected with the virus at birth, also the risk of HIV transmission through ensuing breastfeeding poses a threat of 10-17 percent (roughly that of unprotected heterosexual sex). In consequence, two model community-based programs are currently offering high quality and comprehensive PMTCT in Haiti; St. Boniface Hospital (Fond des Blanc region) and Zanmi Lasante (Central Plateau region). In order to prevent vertical transmission of HIV from mother-to-child, health workers have deployed a variety of evidence-based interventions which include the following: voluntary counseling/testing, antiretroviral therapy, surgical interventions, educational & socio-economic support, nine month supply of infant formula, PCR testing, water sanitation supplies, and pairing the family with a community health worker. The comprehensive PMTCT is offered in the context of accessible primary health care for both mother and child and the programs strive to provide these high-quality services at no or minimal cost to their patients. The results of this program have been promising, recently Zanmi Lasante reported a 10 percent drop in rates of vertical transmission in there catchment area, with an overall vertical transmission rate of just 2 percent.

Learning Objectives: