HIV Seroprevalence Among Pregnant Women in Rural Maharashtra

BackgroundHuman Immunodeficiency virus (HIV) transmission is widespread across the globe. Millions of pregnant women are affected due to the high risk behaviour of their partners. Mother-to-child vertical transmission, has increased the burden of paediatric HIV population. Method A retrospective analysis of data on the utilisation of Integrated Counselling and Training Centre (ICTC) services by pregnant women at a tertiary care hospital in Ahmednagar district of Maharashtra, India from 1 January 2003 to 31 December, 2009. Pre-test counselling, HIV testing and post-test counselling was done by the trained staff of an ICTC centre as per National AIDS Control Organisation (NACO) guidelines. Anti-retroviral prophylaxis in the form of single dose oral Nevirapine (200mg) was given to seropositive women during active labour. Nevirapine syrup was administered to newborn babies. Analysis of the demographic profile of seropositive women was done.ResultsOut of 12,719 pregnant women attending the antenatal clinic, 10,491 (82.48%) accepted pre-test counselling and HIV testing. One hundred and forty-five women were found to be seropositive with a seroprevalence rate of 1.38%; 11% did not come for collection of the laboratory report and missed the post-test counselling. Most of the seropositive women belonged to rural areas (81.37%), had low-socioeconomic status (77.93%), were illiterate, and were unaware of their serostatus and their husband’s risk behaviour. Less than 30% of women were using contraceptives. After registration, the majority of seropositive women (89.65%) attended the antenatal clinic regularly; 11% opted for pregnancy termination; 76% delivered vaginally and 12% underwent Caesarean section. A further 86% of women and 80% of newborns received Nevirapine prophylaxis. Postnatal follow-up of babies was very limited.ConclusionHIV seroprevalence among the pregnant population is declining steadily. More and more women are availing the facilities of ICTC centres. Integration of PPTCT (Prevention of Parent To Child Transmission) and RNTCP (Revised National Tuberculosis Control Programme) has improved the uptake of services. Free Anti-Retroviral Treatment (ART) for seropositives will help in controlling the disease progression and will reduce the vertical transmission