Integrating HIV/AIDS services with antenatal and delivery care: A comparison between the PMTCT Programs in Haiti, the Dominican Republic and Nicaragua

With a prevalence rate among the adult population of 5.6%, 1.7% and 0.2%, respectively, Haiti, the Dominican Republic and Nicaragua offer different, but complementary, scenarios of the presence of HIV/AIDS and the organized response to this disease in Latin America. All these countries are recipients of the Global Fund to Fight HIV/AIDS and have implemented complex programs to prevent the dissemination of the disease and to provide integral care to persons living with HIV/AIDS. In this paper we compare the experience, achievements and obstacles to adequate implementation of the program to prevent mother-to-child transmission of HIV/AIDS in these three countries. Data come from a situational analysis of antenatal, delivery and postpartum care and the program to prevent mother-to-child transmission of HIV/AIDS (PMTCT) conducted by the Population Council in each country. Results from this study show that in the three countries the norms and guidelines of the PMTCT program respond to international recommended practices, and that in particular they reflect the recommendations of the WHO. Nevertheless, have several shortfalls that respond to the lack of coordination between institutions, the lack of material and human resources, including adequately trained staff, and the difficulty of coordinating different services with the same health centers. Family planning services are particularly disconnected from the program to Prevent Mother-to-Child Transmission of HIV/AIDS (PMTCT) and the Units of Integral Attention to Women Living with HIV/AIDS (UAIs). Services provided by the PMTCT program and UAIs do not include any family planning counseling for HIV+ women.