Implementation of PMTCT in Georgia.

To review the existing experience in prevention of Mother-To-Child Transmission (PMTCT) of HIV in Georgia the comprehensive PMTCT state program was started in 2005. Georgia was the first among the former Soviet Countries that ensured the universal access to PMTCT throughout the Country. According to the National PMTCT protocol, all pregnant women are offered Voluntary Counseling and Testing for HIV infection at Women Health Centers, maternity hospitals, and regional hospitals of Georgia. Positive results are referred to the Infectious Diseases, AIDS and Clinical Immunology Research Center (IDACIRC) for the confirmation and management that implies: antiretroviral therapy, caesarean section, infant feeding by formula and PCP prophylaxis by TMP-CTX. Data were collected using National HIV/AIDS Data Base. Prevalence of HIV among pregnant women attending VCT services in 2005-2008 years was 0.03%. Throughout the period 1999-2008 total 84 pregnancies were registered at the IDACIRC, among them 77 pregnancies were monitored by IDACIRC. Prophylactic strategy was tailored individually according to the national acting guideline, women gestation age, HIV disease stage, ARV's availability, etc. Totally 36 pregnant women received full PMTCT service. In this group no vertical transmission of HIV infection was recorded. 33 pregnant women received partial PMTCT service. The reasons were: late HIV diagnosis, limited access to ARV (from 1999 till 2004), refusal by pregnant woman. Number of HIV transmission cases was 3 in this group. As of November, 2008 eight women are still pregnant. Since 2005 Georgia ensured comprehensive and sustainable PMTCT service throughout the Country and universal access for all pregnant women. Provision of full package of this service minimized the risk of vertical transmission.