Declining Rate of Infection with Maternal Human Immunodeficiency Virus at Delivery Units in North-Central Nigeria

HIV testing during labour and delivery provides a critical opportunity for administering appropriate interventions to prevent mother-to-child-transmission (PMTCT). We studied current HIV rates and infection trend among women tested during delivery following scale-up of PMTCT and antiretroviral therapy (ART) programs in Jos, north central Nigeria. Between March 2010 and January 2012, provider-initiated HIV testing and counselling was offered in early labour. Women were recruited from a government tertiary health centre, a faith-based hospital, and a private health centre. Those who previously tested HIV negative during antenatal care (ANC) and those who presented at the labour ward with unknown HIV status were tested. A total of 944 subjects (727 re-tested for HIV infection and 217 with unknown HIV status) were enrolled and tested during labour. The HIV incidence and sero-conversion rates during pregnancy among women who repeated HIV testing at delivery was 1.7 per 100 person-years of observation (pyo) and 0.6% (4/727), respectively, while the rate among those who tested for the first time in labour was 1.8% (4/217). Women who accessed ANC were older and had achieved a higher educational status than those who did not access ANC. A 3- to 5-fold decline in HIV incidence and prevalence rates was detected among women tested at delivery when compared to data from a report in 2004. It is not certain whether the decline in maternal HIV infection is due to the major state-wide scale-up of PMTCT and HIV treatment programs. A broader and purposefully designed evaluation study would be required to verify observed occurrence. Le dépistage du VIH pendant l'accouchement offre une occasion cruciale pour la gestion des interventions appropriées pour prévenir la transmission de la mère - à - l'enfant (PTME). Nous avons étudié les taux actuels de VIH et les tendances de l'infection chez les femmes qui ont subi l'analyse pendant l'accouchement suite à l'intensification des programmes de la PTME et le traitement antirétroviral ( ART ) à Jos, dans le centre nord du Nigeria PTME et. Entre mars 2010 et janvier 2012 à l'initiative des dispensateurs le conseil et du dépistage ont été offerts en début de travail. Les femmes ont été recrutées dans un centre de santé tertiaire gouvernemental, un hôpital confessionnel et un centre de santé privé. Celles qui séronégatives lors des soins prénatals (SP) et celle qui se sont présentées à la salle de travail avec la condition du VIH inconnu