An Integrated City-Driven Perinatal HIV Prevention Program Covering 1.8 Million Pregnant Women in Shenzhen, China, 2000 to 2010

Song, Junmin MD*; Feng, Tiejian MD; Bulterys, Marc MD, PhD; Zhang, Dan MD§; Korhonen, Christine MPH; Shi, Xiangdong MD*; Wang, Xiaohui PhD*; Cheng, Jinquan PhD*; Chen, Lin MD*; Ma, Hanwu MD*

Sexually Transmitted Diseases:
doi: 10.1097/OLQ.0b013e3182805186
Original Study
Abstract

Background: Despite the scale-up of prevention of mother-to-child transmission (PMTCT) programs worldwide, the translation from research studies into public health policy has been slow. This report details the experiences of a city-driven PMTCT program in China using existing health resources.

Methods: The PMTCT program was devised to hospital based and city-wide. It achieves full use of available resources: the local Centers for Disease Control and Prevention, the Infectious Disease Hospital, Maternal and Child Health Hospitals, and all qualified comprehensive hospitals.

Results: From 2000 to 2010, 1,843,122 pregnant women attended prenatal care or labor and delivery services. Overall, 97.4% received pretest HIV counseling, and 96.2% were tested for HIV. Among the 81.1% (1,495,122) of women who attended prenatal clinics, 97.2% (1,452,753) received pretest counseling and 95.7% (1,430,799) were tested for HIV. Among the 18.9% (348,000) of women with an undocumented HIV status at labor and delivery, 98.6% (343,038) received pretest counseling, and 98.1% (341,371) were tested for HIV. In total, 229 women were determined HIV positive for a prevalence of 1.3 per 10,000 pregnant women. Among the 107 HIV-infected women who carried to delivery, 87.9% received antiretroviral prophylaxis for themselves and their infants. Among the 58 women who were identified HIV positive at labor, 10.3% of mothers and 72.4% of infants received antiretroviral prophylaxis. The estimated mother-to-child transmission rate was 5.3% (95% confidence interval, 2.2%–10.7%).

Conclusions: With appropriate integration, existing health care resources are adequate for a comprehensive city-driven PMTCT program in an area with a low HIV prevalence.

In Brief

A city-driven prevention of mother-to-child transmission program in Shenzhen, China, showed that with appropriate integration, existing health care resources were adequate for a hospital-based comprehensive prevention of mother-to-child transmission program.

Author Information

From the *Shenzhen Center for Disease Control and Prevention, Shenzhen, China; †Shenzhen Center for Chronic Disease Control, Shenzhen, China; ‡Global AIDS Program, US Centers for Disease Control and Prevention, Beijing, China; and §The Health, Population and Family Planning Commission of Shenzhen Municipality, Shenzhen, China.

The authors thank all participants from Shenzhen Center for Disease Control and Prevention (CDC), Maternal and Child Health Hospitals, the Infectious Disease Hospital, and all comprehensive hospitals in Shenzhen city. They also thank the National Center for Women and Children’s Health, China CDC, Beijing; The Guangdong Women and Children’s Hospital and Health Institute; and the Health, Population and Family Planning Commission of Shenzhen Municipality for guidance and support. The US CDC Global AIDS Program has provided technical support and guidance for program development in collaboration with Shenzhen City CDC since 2008.

Funding: This work received financial support from both the local government and transfer payments from the central government of China.

Competing interests: None of the authors report any financial relationships or other conflicts of interest.

Disclaimer: The findings and conclusions in this article are those of the authors and do not necessarily represent the views of the US Centers for Disease Control and Prevention.

Correspondence: Jinquan Cheng, PhD, Shenzhen Center for Disease Control and Prevention, Shenzhen, China. E-mail: cjinquan@szcdc.net; Lin Chen, MD, Shenzhen Center for Disease Control and Prevention, Shenzhen, 8 Longyuan Rd, Nanshan District, Shenzhen, Guangdong Province, China. E-mail: clsz109@hotmail.com.

Received for publication September 14, 2012, and accepted November 28, 2012.

© Copyright 2013 American Sexually Transmitted Diseases Association