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Frerichs, R.R. Preventing Mother-to-Child HIV Transmission in Thailand. 

SEA-AIDS Network, November 27, 1998.

R.R. Frerichs Posting

Health officials and researchers in Thailand have moved quickly to address mother-to-child HIV transmission. A summary of the Thai situation appeared in today's Bangkok Post (see below). Are other Asian nations having similar success with establishing programs to reduce mother-to-child transmission? If so, how is the information on the HIV status of mother and child being shared with the husbands? Are efforts underway to work with discordant married couples (i.e., one is infected and the other is not) to limit further viral spread? Please share your successful experiences so that others in Asia learn what is possible, and what needs to be done.

"Better care for HIV-positive mothers and babies urged -- Princess wants govt to allocate more funds" Aphaluck Bhatiasevi, The Bangkok Post, November 25, 1998

The Health Ministry should give more importance to perinatal transmission of HIV, Her Royal Highness Princess Soamsawali said yesterday. Despite economic difficulties, the government should allocate more funds to HIV-positive mothers and their babies, Princess Soamsawali said at the annual meeting of a Thai Red Cross Society project on perinatal transmission. Though the government has increased the Aids budget from five to 10 percent over five years, it was insufficient in light of a rapidly increasing nationwide problem.

Expressing concern about continuity of support, she said the ministry should extend the provision of free infant formula as a breastmilk substitute to children beyond one year. Under the ministry's free infant formula programme, powdered milk is provided to children born to HIV-positive mothers only in the first year. If the provision was extended, she said, those mothers would be encouraged to return to hospitals. A problem identified in many hospitals treating perinatal HIV cases is they are not able to follow up on the health of children, particularly those whose parents move around. In addition, she said, not all mothers-to-be receive anti-retroviral drugs that have proven effective in reducing HIV transmission.

This year, the ministry plans to help 6,900 children born to HIV-positive women and allocate anti-retroviral drugs to 1,600 mothers as part of a programme already under way in some provinces in the North and Northeast. In fiscal 1999, the ministry plans to expand provision of anti-retroviral drugs to seven provinces in the East, 12 in the Northeast and seven in the South.

The society has allocated AZT to 2,100 HIV-positive mothers up to October, a 26 per cent rise on last year. Praphan Phanuphak, director of the society's Aids programme, said funding is not a problem so much as awareness among hospitals of the perinatal programme. In its anti-retroviral drugs programme, which is in line with Aids Clinical Trial Group 076 of the United States, the society provides 100mg of AZT five times a day from 14-34 weeks of pregnancy until delivery and intravenously to newborns. The ministry, however, provides AZT on a short course basis, which involves provision of 300mg twice a day a month before delivery.

Princess Soamsawali also urged authorities to be careful to ensure their prevention campaigns do not foster negative attitudes but make society accept people with HIV. Doctors and medical staff should also be more sensitive to HIV-positive people, many of whom have been reluctant to seek help in the early stages of infection.