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The number of new paediatric infections have declined three- fold since 2002 and states like Maharashtra, Andhra Pradesh, Tamil Nadu, Karnataka and Mizoram are set to reach the target of reducing the transmission of HIV from mother to child to less than five per cent.
National AIDS Control Organisation (NACO) officials told The Indian Express that in 2016-17, the HIV positivity rate among 21 million pregnant women was .08 per cent. While the validation process is underway for the five states, according to NACO officials, the transmission of HIV from mother to child has reduced to less than five per cent.
The National Strategic Plan for HIV/AIDS and Sexually Transmitted Infections (STIs), 2017-2024, aims at realising the “Three Zeros” — zero new infections, zero AIDS-related deaths and zero discrimination. The elimination of mother-to-child transmission of HIV and Syphilis has to be achieved by 2020, as per the national and global commitments, officials said.
It means testing of 95 per cent of pregnant women for HIV and Syphilis, putting 95 per cent of the estimated positive pregnant women on anti-retroviral therapy and achieving a mother-to-child transmission rate of less than 5 per cent by 2020.
Mother-to-child transmission of HIV occurs during pregnancy, labour and breastfeeding. To reduce the risk of transmission of the virus among newborns, a triple drug regimen had been introduced in 2013-14 and instead of a single drug, an HIV positive pregnant woman was given a three-drug regimen that consisted of lamivudine, efavirenz and tenofovir.
Earlier, an HIV positive
pregnant woman was given a single drug therapy (nevirapine).
At the Maharashtra State AIDS Control Society, officials said that in 2017-18, a total of 22 lakh pregnant women had been enrolled and HIV tests were conducted. A total of 936 women had HIV and and hence, the positivity rate among these women was .04 per cent, which is less than the national average, officials said.
While 1,160 babies were tested, a total of 52 were tested positive with HIV, bringing down the mother-to-child transmission rate to 4.48 per cent. Equally important is the case rate, which means that for every one lakh babies born, there should be less than or equal to 50 babies who have HIV.
In Maharashtra, there were 56 such babies for 1.9 lakh newborns.
While NACO officials said the universal HIV and syphilis screening has been made part of routine antenatal care at all primary health centres, incentives are also given to auxiliary nursing midwives and Accredited Social Health Activists (ASHA) to ensure that HIV positive pregnant women avail of various services.
Dr S A Sangle, the Head of the Department of Medicine at B J Medical College, said that earlier anti-retroviral therapy was given to HIV positive persons whose CD 4 count was less than 200.
Now, with tests and treatment, the number of those with the infection has come down. Triple drug therapy decreases the viral load substantially, and paves way for normal delivery and breast feeding.
Dr Ramesh Bhosale, Professor at the Department of Obstetrics and Gynaecology at B J Medical College and Sassoon General Hospital, said: “In the past four years, for instance, of the 171 HIV positive women who delivered at the government-run hospitals, only four babies had the infection.”