Tamil Nadu far behind Cuba to fully eliminated mother-to-child transmission of HIV

CHENNAI: On Wednesday, Cuba became the first country in the world to receive validation from WHO that it successfully eliminated mother-to-child transmission of HIV and syphilis. However, Tamil Nadu still has a long way to catch up.“Emulating Cuba is a far-way thought. To eliminate the transmission of this virus from mother-to child is extremely difficult. As of now we are still a long way behind,” said Dr E. Suresh, Senior Medical Officer, Institute of Child Health and Hospital for Children.

“The real message of PTCT (parent to child transmission) must reach the people and it is not happening right now. How can it be eliminated unless there is proper awareness,” he asked.
He said Tamil Nadu was among six states where the problem was highly prevalent. The areas on the Andhra Pradesh Tamil Nadu border were the worst affected. “Early detection and early intervention can prevent the transmission of the virus, that is if detected in the trimester (first three months of pregnancy) period. But people in the rural areas do not come forth. There is high level of ignorance due to which they try to avoid such situations,” said Suresh.

Meanwhile, R. Leelakrishnan, Joint Director, Tamil Nadu Aids Control Centre (TANSAC), said “It is impossible to make it zero. We are going step by step. It will take time. As of now there is no scope of eliminating it.”Proving this fact is a study ( Knowledge of antiretrovirals (ARVs) in preventing parent-to-child-transmission of HIV: a cross-sectional study among women living with HIV in Tamil Nadu) conducted by Dr Saumya Rastogi (primary author) and Dr Bimal Charles and Dr Asirvatham E Sam, co-authors, published in WHO’s South-East Asia Journal of Public Health (2012).
The study specifically pointed to the fact that nearly one fifth (18.8%) of women with HIV who were surveyed had not heard of PTCT and 40% did not know that ARVs could prevent PTCT.

In addition, 39.3% were not aware of the timing of PTCT . Multivariate analysis also showed that single/never married women had lower knowledge of PTCT. Further, in rural South India, another 48% pregnant women did not know of means to prevent PTCT. Hence, considering the risk of HIV transmission from HIV-infected women to their children and the knowledge level of PTCT among them being low, the study too called for appropriate strategies to generate awareness among women with HIV.

As far as counselling was concerned, the research said that the content of counselling services provided by the Integrated counselling and testing centers (ICTCs) should also be revised to lay more emphasis on prevention of PTCT of HIV. “However, now the number of cases have gone down to less than 1%. Earlier the percentage of transmission was 3-5%. This has been helped by the efficient TLE (Tenofovir, Lamivudine and Efavirenz (TLE)) regimen. TLE decreases the load of the virus in the mother and in turn prevents its transmission to the fetus. Also, the mothers if they opt for replacement feeding the chances of virus transmission again get lower,” Suresh said adding “But still the fact remains that the public needs to be made aware of such things.”,
Stressing on the fact that the health system is not exactly in the best of shape, doctors added that funds were also being gradually directed to address other health related issues like diabetes.