How Thailand eliminated mother-to-child HIV transmission

February 8, 2017, Taylor & Francis

Thailand has become the first Asian country to eliminate mother-to-child transmission (MTCT) of HIV, thanks to a pragmatic multi-sector response backed by strong political commitment and heavy government investment, a study published in Paediatrics and International Child Health reports.

Such an early, concerted response allowed the country to successfully address the four prongs of the recommended World Health Organization (WHO) elimination strategy. As a result, MTCT rates were reduced from 20-40% in the mid-1990s to 1.9% in 2015 (surpassing the WHO elimination target of <2%).

The WHO strategy focuses on the following four prongs: primary prevention of HIV in women of childbearing age; prevention of unintended pregnancies in women living with HIV; prevention of HIV transmission from an HIV-infected woman to her infant; and provision of appropriate treatment, care and support to women and children living with HIV.

In Thailand, initiatives to promote condom use, provide information about the risk of transmission and introduce testing for pregnant and post-partum women were successfully implemented. For example, the 100% Condom Programme, which promotes 100% condom use by male patrons of commercial sex workers, has played a crucial role in preventing HIV infection in women of reproductive age.

The success of such initiatives resulted in part from strong political leadership - the national AIDS policy of Thailand was transferred from the Ministry of Public Health to the Office of the Prime Minister in 1991 - and greatly increased investment, with government spending on the HIV/AIDS programme rising from US$684,000 in 1988 to US$82 million by 1997.

The high rate of antenatal care provision in Thailand is also key. A voluntary HIV test with same-day results is offered at the first clinic visit, followed by re-testing later in pregnancy for HIV-negative women. For HIV-infected pregnant women, antiretroviral therapy (ART) is provided as soon as possible. Such treatment is now available at much lower cost, thanks to legislative changes which have allowed the non-commercial production of generic ART in Thailand. Counselling services at antenatal clinics also promote the use of dual methods of contraception to prevent unintended pregnancy in women with HIV.

The study's author, Professor Usa Thisyakorn of Chulalongkorn University, Bangkok said: "Thailand has achieved WHO elimination of mother-to-child HIV transmission targets with early and concerted efforts of all sectors of Thai society. This provided numerous lessons learned in working together to safeguard children. Since children are the country's future, how the country responds to the problems created for them indicates how highly the country values its future."

Explore further: Thailand, Belarus, Armenia eliminate mother-child HIV spread

More information: Paediatrics and International Child Health, DOI: 10.1080/20469047.2017.1281873

Related Stories

Thailand, Belarus, Armenia eliminate mother-child HIV spread

June 7, 2016
Thailand has become the first country in Asia to eliminate mother-to-child transmission of HIV and syphilis, the World Health Organization announced Tuesday.

Swaziland likely to be first to eliminate malaria in Southern Africa

December 1, 2015
The Malaria Elimination Group, an independent international advisory group on malaria elimination convened by the Global Health Group at the University of California, San Francisco (UCSF), gathered in the Ezulwini Valley ...

Cuba becomes first nation to eliminate mother-to-child HIV

June 30, 2015
Cuba on Tuesday became the first country in the world to eliminate mother-to-child transmission of HIV and syphilis, the World Health Organization said.

Risk of HIV infection is high during pregnancy and the postpartum period

February 25, 2014
Women living in world regions where HIV infection is common are at high risk of acquiring HIV infection during pregnancy and the postpartum period, according to a study by US researchers published in this week's PLOS Medicine. ...

Recommended for you

HIV-1 viruses transmitted at birth are resistant to antibodies in mother's blood

April 19, 2018
Of the genetically diverse population of HIV-1 viruses present in an infected pregnant woman, the few she might transmit to her child during delivery are resistant to attack by antibodies in her blood, according to new research ...

Top HIV cure research team refutes major recent results on how to identify HIV persistence

April 18, 2018
An international team focused on HIV cure research spearheaded by The Wistar Institute in collaboration with the University of Pennsylvania and Vall d'Hebron Research Institute (VHIR) in Barcelona, Spain, established that ...

Scientists discover new way that HIV evades the immune system

April 17, 2018
Scientists have just discovered a new mechanism by which HIV evades the immune system, and which shows precisely how the virus avoids elimination. The new research shows that HIV targets and disables a pathway involving a ...

Team develops new way to fight HIV transmission

April 16, 2018
Scientists at the University of Waterloo have developed a new tool to protect women from HIV infection.

Genetically altered broadly neutralizing antibodies protect monkeys from HIV-like virus

April 16, 2018
Two genetically modified broadly neutralizing antibodies (bNAbs) protected rhesus macaques from an HIV-like virus, report scientists at the National Institute of Allergy and Infectious Diseases (NIAID), part of the National ...

How does HIV escape cellular booby traps?

April 5, 2018
HIV is believed to have evolved from a simian immunodeficiency virus, or SIV, that originated in chimpanzees. How SIV made the species jump has remained a mystery, since humans possess a defense mechanism that should prevent ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.