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Publication Type
Book Chapter
UWI Author(s)
Author, Analytic
Christie, Celia D.; Steel-Duncan, Julianne C.
Author Affiliation, Ana.
Department of Obstetrics, Gynaecology and Child Health
Title, Analytic
A paediatric and perinatal HIV/AIDS leadership initiative in Kingston, Jamaica
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Title, Monographic
Research for Development, Research Fellowship Programme
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Place of Publication
Kingston, Jamaica
Publisher Name
University of the West Indies
Date of Publication
2006
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Page(s)
25
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Abstract
Background: In Jamaica 1-2% of pregnant women are HIV-positive; 876 HIV-positive pregnant women will deliver and at least 283 newly infected HIV-infected infants will be born this year; HIV/AIDS is now the leading cause of death in children aged 1-4 years. Methods: We describe a collaborative 'Town and Gown' program to address the pediatric and perinatal HIV epidemic in Kingston. A team of academic and government healthcare personnel, comprising pediatricians, obstetricians, public health practitioners, nurses, microbiologists, data management and information technology personnel collaborated to address this public health emergency using protocol-driven methods. Results: A five-point plan is being implemented. This comprised leadership and training of a core group of pediatric/perinatal HIV professionals to serve Kingston and be a model for the rest of Jamaica. We are preventing mother-to-child transmission of HIV/AIDS by counseling and HIV-testing women in the antenatal clinics and the three major maternity centers, giving AZT to HIV+ pregnant women beginning at 28 weeks gestation, throughout labor and to the HIV-exposed infants for the first six weeks of life. We have developed and implemented a unified parallel program for identifying the HIV-infected infant and delivering pediatric HIV care at the three major pediatric centers. We are HIV-testing about 30,000 pregnant women, identifying 600 HIV-exposed babies and preventing 140 pediatric HIV infections in three years. We are building research capacity which emphasizes a strong outcomes-based research agenda. This includes pMTCT, natural history of pediatric HIV, initiation of anti-retroviral therapy, adherence to therapy, cost-effectiveness of interventions and implementation of clinical trials. We are collaborating locally, regionally and internationally. Conclusion Together, we can continue to achieve our mission of reducing mother-to-child transmission of HIV/AIDS, while improving the quality of life for those women, children and families who are already living and affected by HIV/AIDS. ....
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