Establishing Family-Based HIV Treatment Programs in Sub-Saharan Africa and Thailand

Treating mothers while preventing mother-to-child transmission: The MTCT-Plus Initiative

Field of Work: Treatment for HIV in sub-Saharan Africa and Thailand

Problem Synopsis: Mothers and children suffer the heaviest toll in the worldwide battle with HIV/AIDS, particularly in sub-Saharan Africa. Each year, more than 2.5 million women become infected, and more than 500,000 transmit the virus to their infants. Progress has been made in the prevention of mother–to-child transmission of HIV. However, these programs offer no HIV treatment for the mothers themselves. As a result, many of the children saved by treatment programs are likely to be motherless by the time they can walk.

Synopsis of the Work: Columbia University Mailman School of Public Health conducted the Mother-To-Child Transmission-Plus Initiative (MTCT-Plus) to link prevention with care and treatment for HIV-infected women and their families. The initiative established 14 family-based HIV care and treatment program sites in eight countries in sub-Saharan Africa and one in Asia.

Key Results: The initiative provided HIV care and treatment to 16,499 adult and child patients and 306 HIV infected clinical staff members.

Among the patients, 3,894 adults and 530 children were eligible for and initiated on an antiretroviral treatment regimen. Nearly 80 percent of the patients receiving antiretroviral therapy were still in active care at 30 months of treatment. This helped to reduce the rate of perinatal HIV transmission to 5.9 percent.

In 2004, the Mailman School of Public Health established the International Center for AIDS Care and Treatment Programs to carry on the work pioneered by the MTCT-Plus Initiative. The center, funded by a $125 million grant from the U.S. government, works with national and local partners to support HIV prevention, care and treatment services worldwide.