Five-year trends in epidemiology and prevention of mother-to-child HIV transmission, St. Petersburg, Russia: results from perinatal HIV surveillance

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  • Kissin, Dmitry M
    • Other Affiliation: Centers for Disease Control and Prevention, 4770 Buford Highway NE, MS K-34, Atlanta, Georgia 30341, USA
  • Mandel, Michele G
    • Other Affiliation: Centers for Disease Control and Prevention, 4770 Buford Highway NE, MS K-34, Atlanta, Georgia 30341, USA
  • Akatova, Natalia
    • Other Affiliation: City AIDS Center, 12 Bumazgnaya Street, St. Petersburg 198020, Russia
  • Belyakov, Nikolay A
    • Other Affiliation: City AIDS Center, 12 Bumazgnaya Street, St. Petersburg 198020, Russia
  • Rakhmanova, Aza G
    • Other Affiliation: City Health Committee, 12 Bumazgnaya Street, St. Petersburg 198020, Russia
  • Voronin, Evgeny E
    • Other Affiliation: Republican Hospital of Infectious Diseases Clinical AIDS Center, January 9th Prospect, Ust Izgora 196645, Russia
  • Volkova, Galina V
    • Other Affiliation: City AIDS Center, 12 Bumazgnaya Street, St. Petersburg 198020, Russia
  • Yakovlev, Alexey A
    • Other Affiliation: Botkin Hospital of Infectious Diseases, 3 Mirgorodskaya Street, St. Petersburg 191167, Russia
  • Jamieson, Denise J
    • Other Affiliation: Centers for Disease Control and Prevention, 4770 Buford Highway NE, MS K-34, Atlanta, Georgia 30341, USA
  • Vitek, Charles
    • Other Affiliation: Centers for Disease Control and Prevention, 19 Nizhny Val, Kiev 04071, Ukraine
  • Robinson, Joanna
    • Other Affiliation: Elizabeth Glaser Pediatric AIDS Foundation, 11150 Santa Monica Boulevard, Suite 1050, Los Angeles, California 90025, USA
  • Miller, William
  • Hillis, Susan
    • Other Affiliation: Centers for Disease Control and Prevention, 4770 Buford Highway NE, MS K-34, Atlanta, Georgia 30341, USA
Abstract
  • Abstract Background The HIV epidemic in Russia has increasingly involved reproductive-aged women, which may increase perinatal HIV transmission. Methods Standard HIV case-reporting and enhanced perinatal HIV surveillance systems were used for prospective assessment of HIV-infected women giving birth in St. Petersburg, Russia, during 2004-2008. Trends in social, perinatal, and clinical factors influencing mother-to-child HIV transmission stratified by history of injection drug use, and rates of perinatal HIV transmission were assessed using two-sided χ2 or Cochran-Armitage tests. Results Among HIV-infected women who gave birth, the proportion of women who self-reported ever using injection drugs (IDUs) decreased from 62% in 2004 to 41% in 2008 (P < 0.0001). Programmatic improvements led to increased uptake of the following clinical services from 2004 to 2008 (all P < 0.01): initiation of antiretroviral prophylaxis at ≤28 weeks gestation (IDUs 44%-54%, non-IDUs 45%-72%), monitoring of immunologic (IDUs 48%-64%, non-IDUs 58%-80%) and virologic status (IDUs 8%-58%, non-IDUs 10%-75%), dual/triple antiretroviral prophylaxis (IDUs 9%-44%, non-IDUs 14%-59%). After initial increase from 5.3% (95% confidence interval [CI] 3.5%-7.8%) in 2004 to 8.5% (CI 6.1%-11.7%) in 2005 (P < 0.05), perinatal HIV transmission decreased to 5.3% (CI 3.4%-8.3%) in 2006, and 3.2% (CI 1.7%-5.8%) in 2007 (P for trend <0.05). However, the proportion of women without prenatal care and without HIV testing before labor and delivery remained unchanged. Conclusions Reduced proportion of IDUs and improved clinical services among HIV-infected women giving birth were accompanied by decreased perinatal HIV transmission, which can be further reduced by increasing outreach and HIV testing of women before and during pregnancy.
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  • Article
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  • In Copyright
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  • Dmitry M Kissin et al.; licensee BioMed Central Ltd.
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Journal title
  • BMC Infectious Diseases
Journal volume
  • 11
Journal issue
  • 1
Page start
  • 292
Language
  • English
Is the article or chapter peer-reviewed?
  • Yes
ISSN
  • 1471-2334
Bibliographic citation
  • BMC Infectious Diseases. 2011 Oct 27;11(1):292
Publisher
  • BioMed Central Ltd
Access right
  • Open Access
Date uploaded
  • July 15, 2016

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