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Publication Type
Conference Proceedings
Author, Analytic
Christie, Celia D.C.; Steel-Duncan, J.; Palmer, Paulette; Pierre, Russell; Harvey, K.M.; Johnson, Nadine; Samuels, L.; Dunkley-Thompson, J.; Singh-Minott, Indira.; Anderson-Allen, Millicent; Billings, Collette; Evans-Gilbert, T.; Rodriquez, B.; Moore, Jacynth; McDonald-Kerr, C.; Taylor, F.; Smikle, Monica; Williams, Eric; Whorms, S.; Davis, Denver; Mullings, Anthony; Morgan, Orville; McDonald, D.; Alexander, G.; Onyonyur, A.; Hylton-Kong, T.; Weller, Peter; Harris, Michelle; Haughton, D.; Woodham, A.; Carrington, D.; Figueroa, J.P.....
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Paper/Section Title
Effectiveness of highly active antiretroviral drugs in preventing mother to child HIV transmission and reducing HIV-attributable mortality in Jamaican children.
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Proceedings Title
18th International AIDS Conference: AIDS 2008
Date of Meeting
August 3-8, 2008
Place of Meeting
Mexico City
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Date of Publication
2008
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Abstract
Background: Pediatric and Perinatal HIV/AIDS remains a significant health challenge in the Caribbean, where the HIV sero-prevalence is second only to Sub-Saharan Africa. Methods: We describe a collaborative approach to the prevention, treatment and care of HIV in pregnant women, infants and children in Jamaica. A team of academic and government healthcare personnel collaborated to address the pediatric and perinatal HIV epidemic in Greater Kingston, as a model for implementation throughout the island of Jamaica (population 2.6 million, HIV sero-prevalence 1.6%). Results: During September 2002 to August 2007, over 69,995 pregnant women presented for antenatal care in Kingston, St Andrew and St Catherine, Jamaica. During these five years, significant improvements occurred in uptake of voluntary counseling (from 40% to 91%) and HIV-testing (53% to 102%). Eight hundred and eighty women tested HIV-positive, with sero-prevalence rates of 1-2% each year. Mother to child transmission (MTCT) of HIV/AIDS using modified short course zidovudine or nevirapine in the first 3 years, significantly reduced MTCT of HIV from 29% to 6% (RR 0.27, 95% C.I. (0.10, 0.68). During 2005 to 2007 using maternal highly active antiretroviral therapy (HAART), with zidovudine, lamivudine and nevirapine, or nelfinavir, or lopinavir/ritonavir and infant zidovudine and nevirapine, MTCT was further reduced to an estimated 1.6% in Kingston, St Andrew and St Catherine and 4.75%, island-wide. In 5 years, we evaluated 1,570 children, 24% (377) of whom had HIV/AIDS and 76% (1,193) were HIV-exposed in four, weekly pediatric infectious diseases clinics in Kingston, St Andrew and St Catherine and six rural outreach sites throughout Jamaica. 82% (309 of 377) children with HIV/AIDS initiated HAART with reduced HIV-attributable childhood morbidity and mortality, island-wide.Conclusion: Working together, our mission of preventing mother to child transmission of HIV/AIDS and improving the quality of life for families living and affected by HIV in Jamaica is now being achieved.....
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