1. Situation analisys on HIV vertical transmission
Dr Zhanna Trumova
Republican HIV/AIDS center
The Republic of Kazakhstan

2. Number of HIV-infected people detected in Kazakhstan (per year)

3. Spread of HIV/AIDS in Kazakstan (as of 01.09.03)
59 сл.
58 сл.
705 сл.
196 сл.
56сл.
137 cл.
110 сл.
12 сл.
73 сл.
1210 сл.
38 сл.
19 сл.
7 сл.
62 сл.
185сл.
368 сл.
3788 HIV-cases are registered in Kazakhstan

4. Ways and factors of HIV transmission

5. Prevalence of HIV - infected women by age groups

6. Growth rates of HIV-positive women

7. Number of pregnant women tested for HIV (per year)

8. Number of detected HIV-infected pregnant women

9. Prevalence of HIV-infected pregnant women by region
Total - 205

10. Risk factors for HIV-infected pregnant women

11. Co-factors for HIV-infected pregnant women

12. Pregnancy outcomes

13. Spread of children by region n=75

14. Health status of children born to HIV-infected mothers

15. Antiretroviral therapy of newborn, begun in 2002

16. Feeding of newborn , n=81

17. Proposed preventive treatment schemes
Scheme 1 – ZDV (Protocol 076: from 14th week of pregnancy to delivery (II and III trimesters of pregnancy) 600 mg/pd; from the beginning of labour to delivery 2 mg/kg, then 1 mg/kg intravenous per hour; to the child – suspension ZDV 2 mg/kg every 6 hours in the course of 6 weeks)
Scheme 2 – short-term treatment ZDV from 36th week
Scheme 3 –Nevirapin: the pregnant – 200 mg once in delivery, the child – nevirapin suspension 2 mg/kg once within 72 hours (HIVNET 012, Uganda)

18. Current activities
A Government Dicree # 1207 «Programme on AIDS prevention in Kazakhstan from 2001 till 2005» dated from 14 september 2001 was developed and aproved in Kazakhstan.
Preventive Programmes aare being intriduced with the assistance of international organizations.
Access to counselling and HIV voluntary testing
Pregnant women and children are provided with antiviral medicine and child nutrition free of charge from public funds
Quality medical care and preventive interventions are provided to HIV- infected women during pregnancy and deliveries

19. Challenges
Lack of information and educational materials on «HIV and pregnancy»
Difficulties related to timely detection, registration, examination of people from risk-groups (drug addicts, RKS, etc) including pregnant women
Weak VCT services network in health care, including PHC, obs -genecologi , in particular lack of professional training for health workers in HIV/AIDS consultation
Lack of financing for equipment, test-systems, antiviral medications

20. Possible solutions
Primary prevention among pregnant women, access to HIV/AIDS info, promotion of safe sex, prevetion of unwanted pregnancy, availability of contraceptives, STIs treatment
Introduction of voluntary consultation and testing for target-groups (IDU, CSW, married couples, youth) as a supplement to ongoing prevention programmes
Prevention of mother-to-child HIV transmisstion in antenatal, intranatal and postnatal periods
Access to antiretroviral medications
Artificial feeding
Care and support of HIV-infected women, their children and family members