China AIDS Initiative

Preventing Mother To Child
Transmission (pMTCT) of HIV

Our Mission

Eliminating Pediatric AIDS in China

Antiretroviral treatment provided to HIV-infected mothers during pregnancy and to newborns at birth can reduce the mother-to-child transmission rate to less than 2%.

The China AIDS Initiative is building a comprehensive pMTCT program, working with local healthcare authorities to provide treatment, care and supporting social services in Yunnan province. With support from philanthropists and overseas friends from all sectors of society, CAI has partnered with Dr. Zhou Zengquan at the Yunnan AIDS Initiative to conduct a range of testing and treatment interventions.

The pMTCT program identifies HIV+ pregnant women using the most effective testing methodologies, and provides them with antiretroviral treatment and maternal-child health services. CAI builds local capacity to prevent mother to child transmission by training health workers in prevention and treatment best practices. The project has doubled the number of active counties in 2010 from 13 to 26 of Yunnan's highest prevalence areas, many of which lie along the border with Myanmar and Vietnam.

To date more than 490 HIV+ women have been enrolled in CAI’s mother to child transmission prevention program. Because these women were treated early in their pregnancies with the most effective medicines, only three newborns were diagnosed HIV+, a transmission rate of <1%. Without treatment intervention, about 33% would have been infected.

One Family’s Story

When HIV Strikes Home

Mrs. Zhang and her husband tested HIV+ when she was four months pregnant. Fearful and overwhelmed, they despaired their baby’s fate, and their own. Believing the child would be born infected—or if negative, soon orphaned—abortion seemed the only option.

A Mother’s Hope

Dr. Gao Liping, the Zhangs’ obstetrician, reassured Mrs. Zhang that with timely treatment she could live a long life and likely deliver a healthy baby. Stigma associated with HIV still troubles the family, and they prefer not to be photographed here. But the Zhangs are happy to show off their pride and joy—their eight-month old son.

A Doctor’s Passion

A Selfless Calling

Dr. Gao Liping is faithfully devoted to her work. By day she manages care for all HIV+ pregnant women at the Maternal Child Hospital in Linxiang, Yunnan. At night she visits outlying villages to see patients who cannot travel to the city.

Destinies Changed

Of the nearly 500 infected women Dr. Gao Liping and other project colleagues have treated, just three mothers delivered HIV+ babies. The China AIDS Initiative gives technical and financial support that enables Dr. Gao and other dedicated professionals to provide pMTCT interventions at the highest standards of care. Now Mrs. Zhang laughs, and cries, knowing her son will live out his destiny. Dr. Gao wipes tears away as well, and attends to her next patient. Such joy and sadness are often joined in her work.

What We Do

Raising Clinical and Diagnostic Standards

Working with the Chinese government’s program to prevent mother to child transmission, CAI is introducing best practices to reduce HIV transmission to <2% among enrolled babies. Early infant diagnostics ensure that babies can be identified as HIV positive or negative by 6 weeks of age, rather than waiting until age 18 months.

In addition, our program has piloted an integrated screening package of HIV, Hepatitis, hepatitis B and syphilis for pregnant women. Women diagnosed with any of these three vertically transmitted diseases receive appropriate intervention to benefit their own health and to reduce transmission to their babies.

Training Village, Township, and County Doctors

Village, township, and county doctors are being trained to provide HIV services including counseling, testing, antiretroviral therapy for the mother and baby, c-section if indicated, and reliable supply of formula for replacement feeding.

Counseling and Care

Psychological support is provided to HIV+ women and their families in monthly group meetings facilitated by trained counselors. Women join the group during their pregnancy and continue to participate after their babies are born. The group allows women to share their hardships, worries, hopes and joys in a mutually supportive environment.

Another focus is on keeping HIV-negative women negative through counseling and education, to build awareness of risk and teach methods and skills to reduce it.

Future of the pMTCT Program

These gratifying results are comparable to those realized in large urban centers in the developed world. CAI has successfully built a pMTCT model in rural Yunnan, and now plans to scale up these methodologies to other parts of China affected by the epidemic.

As important, the Chinese national guidelines for pMTCT have recently been changed to recommend many of the interventions that we have championed, including integrated screening for Hepatitis B, syphilis, and HIV and combination antiretroviral therapy for all HIV-infected pregnant women.

With scale up efforts underway, CAI's pMTCT sites in Yunnan are reaching about 60% of the total number of HIV+ pregnant women in the province. If additional resources can be secured, CAI will expand the program’s geographic coverage to an additional nine counties, thereby enabling more women to enroll. Specific goals include:

Increase enrollment of HIV+ pregnant women.

Expand training of village and township level medical workers.

Strengthen social support and psychosocial counseling offered to HIV+ pregnant women.

Continue to advocate among provincial and national health agencies for expansion of the program model to other regions affected by the epidemic.

Please see the February 2010 Journal of AIDS for a detailed analysis of CAI’s pMTCT program.