Thailand aiming to cut HIV transmissions to children

Having already achieved enormous success in driving down rates of HIV transmission from parent to child, members of Thailand’s public health community said last week they are determined to reduce the rate of transmission to less than 1 percent in three years time, giving thousands of children a chance at healthy and better lives.

The effort is being spearheaded by the Thai Red Cross Society, but involves collaboration across the public health sector as well as with nongovernmental organizations. Thai Red Cross Society Secretary-General Phan Wannamethee said health providers have been working hard to achieve the goal of ending this form of transmission of the virus. HIV can be treated but has no cure at this time.

Working under royal patronage, the Red Cross has been engaged in prevention of parent to child transmission (PPTCT) of HIV since 1996. At the time, the rate of transmission from HIV-positive mothers to their children was 10.3 percent. Today, the rate is 1.9 percent.

Dr. Thongchai Lertwilairatanapong, deputy director-general of the Department of Health at the Ministry of Public Health, said getting below 1 percent is a challenging goal. He believes, however, that the rate in Thailand could drop to zero by 2030 if all groups involved work together.

The virus is typically passed to a child during the late stages of pregnancy, during the birthing process, or during breastfeeding. HIV testing and counseling are key to prevention, because many mothers have not been tested and are unaware if they are infected or not.

If a pregnant woman is known to be HIV positive, a regimen of antiretroviral drugs and other treatments have been proven to have an extremely high success rate in preventing her from passing the virus on to her newborn.

With regimens already available to prevent parent-to-child transmission, the factor needed to reduce the rate of transmission is stepped up outreach to vulnerable and most-at-risk communities. These are often, but not solely, poor and marginalized groups, such as intravenous drug users, commercial sex workers, and partners of men who have sex with men.

Such groups are often at odds with, or fearful of government officials, including public health workers, and so can be difficult to reach. While the Red Cross works closely with the Ministry of Public Health, and the ministry is totally supportive of the efforts, partnerships with nongovernmental organizations, civil society and activist groups are critical. These groups are often more trusted by at-risk people and can connect them to the services they need, such as HIV testing, counseling and treatment.