Integration of Prenatal Care with the Testing and Treatment of HIV and Syphilis in Peru

Publication date: 11/30/09
by Arachu Castro, Utpal Sandesara
Socios En Salud
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Integración de la Atención Prenatal con los Procesos de Detección y Manejo Clínico del VIH y de la Sífilis en el Perú

(In English and Spanish)

The Latin American and Caribbean Initiative for the Integration of Prenatal Care with the Testing and Treatment of HIV and Syphilis (ILAP) has the goal to identify existing barriers for testing and treatment of HIV and syphilis during pregnancy in Latin America and the Caribbean and to design an intervention aimed at universalizing the integration of prenatal care with the testing and treatment of HIV and syphilis and strengthening health systems. The development of an operational research strategy oriented towards increasing and improving the diagnosis and treatment of HIV and syphilis during pregnancy has the potential of having enormous implications for public health. ILAP contributes to the early diagnosis and timely treatment of HIV and syphilis in women, to decrease the numbers of mother-to-child transmissions of HIV and congenital syphilis, to provide better care for large numbers of women and children, and to strengthening health systems in an important number of Latin America and the Caribbean countries.

ILAP is conducted collaboratively between the National AIDS Programs from Brazil, Colombia, Cuba, Dominican Republic, Nicaragua, Paraguay, Peru, and Uruguay, the Regional Office of UNICEF for Latin America and the Caribbean, the Regional Support Team of UNAIDS for Latin America, and Harvard Medical School. Experts in each country drive the agenda, set the goals, and commit their own national resources to provide opportunities for families to access quality health care. As a country with a very low mother-to-child transmission of HIV and no congenital syphilis, the role of the Cuban National AIDS Program is to provide advice and technical support, based on their experience providing high-quality care in a low-resource setting. The UN agencies provide technical and logistical assistance and Harvard Medical School coordinates the methodological and analytical development and provides research support at the request of country teams.

When ILAP was launched in Panama City, Panama, in November 2007, country teams and institutions pledged to support one another technically by sharing results and strategies. The group outlined a plan and timetable with a common methodology. At the second meeting, held in Bogotá, Colombia, in March 2008, each country team presented their detailed plan of action along with their priority areas.

Each participating country is represented by a country coordinator who works closely with the director of the National AIDS Program. Each country team selected a number of regions in their country with the purpose of seeking as much variability as possible in terms of differential access to prenatal care, the epidemiology of HIV and syphilis, and social, economic, and political considerations. In each country, the research starts with a situation analysis of current barriers that preclude the integration of prenatal care with the care for HIV and syphilis (Phase 1A), based on which country teams and Harvard Medical School develop a research instrument that is administered to pregnant women (Phase 1B). The instrument is a closed questionnaire that includes a core component similar for all the countries and an additional section that is adapted to the health care situation of each country.

The operational research of Phase 2 has the objective of informing, supporting, and monitoring the required changes to reach the integration of prenatal care with the testing and treatment of HIV and syphilis.


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