Mother-to-child transmission of HIV and syphilis slows down in Caribbean

A new report by the Pan American Health Organization (PAHO) shows that progress towards the elimination of mother-to-child transmission of HIV and syphilis in Latin America and the Caribbean has slowed.

According to the report on the Elimination of Mother-to-Child Transmission of HIV and Syphilis in the Americas: Update 2016, a total of 2,100 children acquired HIV, most of them from maternal-to-child transmission in 2015, 55% less than in 2010. However, this number has slowed down in recent years. While between 2010 and 2011 new cases fell by 800 children, they only fell by 100 between 2014 and 2015.

“Countries have made great efforts to prevent mother-to-child transmission of HIV,” said Marcos Espinal, director of PAHO’s Department of Communicable Diseases and Health Analysis. However, he added: “Every time we get close to eliminating the transmission of a disease, progress is made more difficult because it involves reaching all women, especially those who historically find barriers to accessing health services.”

In 2015, 72% of pregnant women in Latin America and the Caribbean were tested for HIV, and 88% of the women that were positive received treatment, an increase of 16% and 71% since 2010, respectively. Access to treatment, along with other interventions, reduced the rate of mother-to-child transmission of HIV from 15% to 8% in five years in Latin America and the Caribbean. The goal is to reach 2%.

Congenital syphilis cases doubled in five years

The report indicates that new cases of congenital syphilis in Latin America and the Caribbean have doubled since 2010, when countries and territories reported 10,850 cases, showing a steady increase since then. By 2015, an estimated 22,400 children were born with syphilis.

In 2015, 83% of pregnant women in prenatal care were tested for syphilis and 84% of those positive received treatment, rates that have remained stable for five years. Currently, the number of children born with congenital syphilis in the region (170 per 100,000 live births) triples the goal of elimination (50 per 100,000).

“Expanding rapid diagnostic tests and initiating treatment at the same visit, as well as engaging sexual partners of pregnant women diagnosed with syphilis to know their status and treat them, is crucial to avoid reinfection during pregnancy and end this disease by 2030”, said Massimo Ghidinelli, head of the PAHO HIV, STI and Viral Hepatitis Unit.

To reduce as much as possible the number of children who get HIV from their mothers or are born with congenital syphilis, countries need to have at least 95% of pregnant women receiving prenatal care, 95% or more being tested, and at least 95% of those diagnosed, receiving appropriate treatment.

Although the Region of the Americas has not yet eliminated mother-to-child transmission of HIV and syphilis as a public health threat, 18 countries and territories reported data compatible with this double elimination in 2015. Cuba was the first country in the world to be validated by WHO for reaching elimination, and other Caribbean countries and territories are on track to achieve it.

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