Mobile Clinic Voluntary Counseling and Testing and Prevention of Mother-to-child Transmission of HIV in Rural Haiti

摘要

We describe an innovative program for diagnosis and treatment of HIV among pregnant women in rural Haiti. Mobile clinic (MC) testing and treatment by directly observed therapy with antiretrovirals (DOT-ARV) was introduced to a registered population of 175,000 people. The intervention improved access to testing and care for rural women with 3191 women tested in 10 months (92(percent) coverage) and 76(percent) enrolled in a prevention of mother-to-child transmission (PMTCT) program. A high infant mortality rate (IMR) not attributable to diarrheal illness or explained by HIV infection may be related to the loss of protective immunity of breast milk among formula fed infants. Missed and late diagnoses were documented during a period of political instability but the DOT-ARV intervention ensured continuity of care for enrolled patients. This MC DOT-ARV program linked to an equitable food relief program improved access to HIV testing and care for pregnant women in rural Haiti.