Inter Press Service - October 25, 2002
Marcela Valente

Perinatal transmission is the cause of seven percent of HIV/AIDS cases in this Southern Cone country of 37 million.

Infants infected with HIV rarely make it to adulthood, even if they strictly stick to the cocktail retroviral therapies that delay the onset of full-blown AIDS.

The Argentine-Maltese Aid Programme for the Prevention of Perinatal AIDS, which is supported by the Sovereign Order of the Knights of Malta, was put into effect in hospitals in the greater Buenos Aires metropolitan area, which is home to more than 12 million people.

Dr. María Sarubbi, a member of the group of physicians responsible for the project, told IPS that through adequate prenatal controls and treatment, it was possible to reduce the perinatal infection rate (among babies born to HIV-positive mothers) from 25 percent to 2.7 percent.

National AIDS Programme statistics show that 96 percent of HIV- positive children under the age of 13 in Argentina were infected through that mode of transmission, and another two percent through blood transfusions.

With the appearance of increasingly effective combination retroviral therapies, HIV is transmitted to a mere one to three percent of babies born to infected mothers in industrialised countries, compared to an average of 25 percent in developing countries, and as high as 40 percent in some extremely poor areas.

Sarubbi said that under the new programme, all pregnant women attending prenatal visits in the hospitals or coming in for other reasons are tested for HIV/AIDS.

"The women whose results come back negative receive HIV/AIDS prevention outreach, while those who test positive are enrolled in the programme to begin to receive treatment," she said.

Sarubbi explained that although the earlier that an HIV- positive expectant mother begins to be treated, the better, the absolute cut-off date is when she is seven months pregnant. Beyond that limit, the possibility of preventing perinatal infection sharply declines.

Of the 144 women enrolled in the programme so far, half were unaware of their HIV-positive status until they were tested in the hospitals, said Sarubbi.

The governmental National AIDS Programme provides the AIDS tests and antiretroviral drugs, as well as supplies of infant formula to guarantee that infected mothers do not nurse their babies after they are born, because breast-feeding is one of the main routes of mother-child transmission.

However, the test results, antiretroviral drugs and formula do not always arrive on time, said Sarubbi, who underlined that timely provision of the assistance, as well as the resources essential to carrying out effective prevention efforts, is key to the success of the programme.

"The support that we receive from the Knights of Malta has enabled us to make faster decisions, allowing us to detect, for example, which women can have natural childbirths, due to their low viral counts when they come to term," she explained.

The proportion of c-sections for HIV-positive women has been reduced 17 percent among the pregnant women participating in the programme, she pointed out.

Sarubbi and Dr. Liliana Vázquez, co-coordinator of the programme, belong to the Foundation of Infectology Research of Argentina, which is also participating in the prevention programme, along with a United States association, Fighting Infectious Diseases in Emerging Countries.

In Buenos Aires, most women testing positive for AIDS are low- income, and face difficulties of access to health care, Sarubbi explained. In addition, many have unwanted pregnancies, and are unaware that they are infected, or that their young children test positive for HIV.

"Around 20 percent of the pregnant women who come to the hospital to give birth have never received any prenatal controls," she added. (END/IPS/LA/HE/TRA-SO SW/MV/DM/02)

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