elimination of mother to child transmission of hiv and...
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Elimination of mother–to–child transmission of HIV and
congenital syphilis
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Early stages in the Syphilis Control Program
o Dermatologists at dispensaries.
o Not integrated into basic health services
o Insufficient coverage by these services
o Non-existent epidemiological control actions
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o Focus on identifying cases
o Epidemiological research and analysis
o Via community health centers
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1970: Mother and Child Care Program
•At least 10 prenatal controls
•Including STI/ HIV/ AIDS counseling
•Serology and HIV testing to pregnant
women and their partners
•99.9% of births at health institutions
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Antenatal Care
o Periodic
o With a Team approach
o Comprehensive
o Community involved
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Source: EDO Information System and Birth Information System, National Medical Records and
Health Statistics Bureau.
Cases of syphilis in women and congenital syphilisCuba: 1980-2014
Around 1.5 million syphilis serologies per year; more than 300 000 to pregnant women
0,12
0,04
0,030,04
0,06
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• Ministry of Public Health• Ministry of Education• Ministry of Higher Education• Ministry of Tourism• Ministry of Justice• Ministry of Culture• Ministry of Domestic Trade• Ministry of Construction• NGO´s and other associations: FMC,
PVV, CSJ, AHS, other according to local conditions.
• Ministry of Defense
• Ministry of Labor and Social Security• Cuban Radio and Television Institute • Youth organizations• Ministry of Interior
1983: Group coordinating multisectorial response to HIV/AIDS epidemic.
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• Serological screening of population groups
• Epidemiological survey of cases
• Partner Notification
• Ensuring medical care for those affected
• Education of the population
1986: Program for prevention and control of
HIV/AIDS
Identification of priorities
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Network of scientific centers at the serviceof Public Health
Ensured research, development of human resources and introduction of technology for a comprehensive response to HIV / AIDS epidemic
1986: Development of human and material capabilities
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Educational component
Basic strategies
Training
Communication: personal, group and the media
Counseling
Condoms
Intersectoral and community work
More than 13,000 voluntary promoters
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Cumulative statistics, Cuba: 1986- 2014
Source: HIV / AIDS´ computerized registry, MINSAP
Total HIV cases 21 922
Total deaths 3 652 (16,7%)
Persons living with HIV 18 270 (83,3%)
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Cuba 2014: HIV prevalence (%) in population raging 15 - 49 years
2 provinces above the national prevalence
7 provinces prevalence between 0.18 and 0.21%
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HIV cases by sex and sexual orientation among men.
Cuba: 1986-2014
Source: HIV / AIDS´ computerized registry, MINSAP
N= 21,922
N= 17,739
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Prevention of mother- to- child HIV transmission
HIV serology testing in all three trimesters of
pregnancy
Screening of sexual partners
Combined anti-retroviral therapy
Cesarean delivery
Preventive treatment to newborns
The rate of mother- to -child HIV transmission has been
equal to or lower than 2% in the last three years.
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Impact indicator 2012 2013 2014
Mother-to-child transmission rate 1.85 1.74 2.0
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Organization of care for people with HIV
Secondary Health Careo Network of hospitalso Centers of
comprehensive careo Regional Centers
Tertiary Health Care: o “Pedro Kouri” Tropical Medicine
Instituteo Institutes for other specialties.
Primary health careo Family Doctor and Nurse Office
o Polyclinic - specialists trained in STI / HIV / AIDSo Counseling serviceso STD / HIV / AIDS consultations and other services at
polyclinics
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Follow-up studies of people with HIV
Capitán Roberto Fleites Polyclinic
Mario Gutiérrez Polyclinic
Juan Bruno Zayas Hospital
Camilo Cienfuegos Hospital
Manuel Fajardo Hospital
CPHEM,Havana
Luis Pasteur Polyclinic
Tropical Medicine Institute
Mayabeque
San José de la Lajas
9 flow cytometry laboratories
5 viral load laboratories
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PROVINCES
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Antiretroviral treatment in Cuba: 2001-2015
8.102
9.661
13.075
12.026
4.6494.018
3.123
2.581
299 8721.2921.727 2.098
5.692
6734
0
1500
3000
4500
6000
7500
9000
10500
12000
13500
15000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
Source: Computerized registry of HIV / AIDS, MINSAP2015 until 21/06/2015 15
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Steps in the validation process
• Official request to participate in the validation exercise
• Establishment of the country team /preparation of country report
• Establishment of external validation team
• Review of the Regional Validation Committee report
• Pre-validation visit
• Validation visit and field work
• Report by the regional validation team
• Examination of the final report by the World Committee
• Completion of the validation process
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Cuba´s efforts to eliminate syphilis and HIV / AIDS are highlighted
Havana, March 27th , 2015, (AIN)