TAILIEUCHUNG - Programmatic update Use of Antiretroviral Drugs for Treating Pregnant Women and Preventing HIV Infection in Infants

The World Health Organization recognises the quality of the early years as a key social determinant of health17. There are sound theoretical and empirical reasons for focusing mental health promotion interventions on young children to prevent a range of problems in later life18 including mental health problems, obesity, criminality, family violence, poor literacy, unemployment and welfare dependency. Prevention and early intervention is also less expensive and more effective than treatment19. In recent years, the Division’s health promotion services have invested in a number of universal and targeted multi-strategy interventions to improve social and emotional wellbeing in early childhood. These interventions have been conducted with the early childhood education and care sector, child care centres, training institutions. | HIV AIDS Programme PROGRAMMATIC UPDATE USE OF ANTIRETROVIRAL DRUGS FOR TREATING PREGNANT WOMEN AND PREVENTING HIV INFECTION IN INFANTS EXECUTIVE SUMMARY APRIL 2012 World Health Organization EXECUTIVE SUMMARY Recent developments suggest that substantial clinical and programmatic advantages can come from adopting a single universal regimen both to treat HIV-infected pregnant women and to prevent mother-to-child transmission of HIV. This streamlining should maximize PMTCT programme performance through better alignment and linkages with antiretroviral therapy ART programmes at every level of service delivery. One of WHO s two currently recommended PMTCT antiretroviral ARV programme options Option B takes this unified approach. Now a new third option Option B proposes further evolution not only providing the same triple ARV drugs to all HIV-infected pregnant women beginning in the antenatal clinic setting but also continuing this therapy for all of these women for life. Important advantages of Option B include further simplification of regimen and service delivery and harmonization with ART programmes protection against mother-to-child transmission in future pregnancies a continuing prevention benefit against sexual transmission to serodiscordant partners and avoiding stopping and starting of ARV drugs. While these benefits need to be evaluated in programme settings and systems and support requirements need careful consideration this is an appropriate time for countries to start assessing their situation and experience to make optimal programmatic choices. This programmatic update is meant to provide a current perspective for countries on the important changes and new considerations arising since publication of WHO s PMTCT ARV guidelines 2010 version especially as a number of countries are now preparing to adopt Option B . WHO has begun a comprehensive revision of all ARV guidelines including guidance on ARVs for pregnant women planned for release in early 2013. .

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