Performance of the prevention of parent to child transmission program: A decadal trend from rural Maharashtra, India

Background: Human immunodeficiency virus (HIV) infection is widely spread across the state of Maharashtra with high prevalence among antenatal women. Aims: To assess the effectiveness of prevention of parent to child transmission (PPTCT) services in rural Tertiary Health Care Centre of Western Maharashtra, India and to address the weaknesses in functioning of PPTCT services. Materials and Methods: A cross-sectional study was conducted at Integrated Counselling and Testing Centre (ICTC) of a rural tertiary health center located in rural area of Western Maharashtra over a period of 10 years from 2003 to 2012. A total of 32,575 pregnant women were included as study subjects and data were collected as per the indicators of PPTCT by viewing the retrospective PPTCT records. The data were analyzed over the period of 10 years for the outcome of PPTCT services. The trend of PPTCT indicators over a decade were analyzed by using Chi-square test. Results: The seroprevalence of HIV infection among pregnant women was 2% in 2003 which decreased to 0.2% by 2012. The proportions of women counseled and HIV tested were 88.9% and 100%, respectively in 2003 and pretest counseling trend was steadily increased to 100% by 2012; however; HIV testing trend remained 100% throughout 10 years. Posttest counseling trend ranges from 89.6% to 99.9% whereas trend of HIV testing among partners has been fluctuating from 25% to 100%. The proportional trend of HIV-positive mothers delivered in a tertiary care hospital ranges from 60% to 100%. The proportions of pair receiving prophylaxis Nevirapine has been increased from 83.8% to 100% by 2009, but thereafter decreased to 83.3% by 2012. The overall HIV positivity among babies after 18 months of follow-up was 21%. Conclusion: HIV seroprevalence among the pregnant population is steadily declining. More and more women are availing the facilities of ICTC centers. Intensive health education and availability of diagnostic and therapeutic services in rural health center have reduced the burden of HIV/AIDS problem in the rural community.