The project, first of its kind in Romania, was implemented for two years (2000 – 2002) in Constanta County, with three major intervention areas: education, prevention and training.

Through the project activities, 11.423 pregnant women from Constanta County benefited from counseling on HIV infection risks and risks associated with mother-to-child transmission. At the same time, 4 information sessions were organized for 410 specialists working in the field of medical care for pregnant women to improve their professional skills with regard to HIV/AIDS prevention and multidisciplinary care for HIV positive pregnant women and their newborns.

By applying correctly and on time the measures for prevention of mother-to-child transmission, savings of about 800 – 1000 USD/month can be made for each healthy baby born from a HIV positive mother, the equivalent of the ARV therapy.

In successfully implementing this project, Romanian Angel Appeal worked together with a number of partners including the Constanta County General Directorate for Public Health, Constanta Municipal Hospital (“Sunglower” Day Clinic), Constanta County Hospital (the Obstetrics and Gynecology Department), Speranta Asociation, National Committee for Fight against HIV/AIDS within the Ministry of Health, European Forum on HIV, Children, Young People and Families.

The project received financing from:

  • Fundatiei Franco Moschino (Italy)
  • Regione Piemonte (Italy)
  • Elizabeth Glaser Pediatric AIDS Foundation (USA)
  • Padova University – Pediatrics Department (Italy)
  • Torino University – Pediatrics Department (Italy)
  • Delegation of the European Committee
  • UNICEF

The primary objective of the project was to inform and educate pregnant women about the risk of HIV infection and of vertical transmission of the virus in case of infection.

At the same time, the project had a number of complementary objectives such as:

  • To evaluate the proportion of pregnant women who agree to take the HIV test, to evaluate the feasibility at starting antiretroviral therapy for HIV positive pregnant women and the babies HIV infected at birth;
  • To evaluate the HIV incidence and mother-to-child transmission rate and the factors that can influence it;
  • To improve the quality of medical and psychosocial support provided to HIV infected women and to their newborns, to fight discrimination and marginalization of HIV positive people as well as to promote information exchange among professionals involved in providing multidisciplinary care to the HIV positive pregnant woman.

Some of the project beneficiaries were:

  • 11.423 pregnant women from Constanta County, HIV counseled and tested;
  • Over 400 family doctors, obstetricians, gynecologists and nurses involved in providing medical care for the pregnant women.

The project activities covered three major intervention areas:

  1. education;
  2. prevention;
  3. training

Education:

11.423 pregnant women were counseled about HIV transmission risks as well as the risk for vertical transmission. In addition, the pregnant women received information about the importance of HIV testing and of the use of contraceptives and protection in case of infection.

12.000 brochures were printed and distributed: “What every pregnant woman should know”, “Keep on living – leaflet for HIV positive pregnant women” and the “Guide for family doctors”. The Manual for HIV positive pregnant woman care was also printed in December 2002.

Prevention:

Of the total number of pregnant women who were counseled and HIV tested, 20 were found positive. Following the proper protocol for HIV mother-to-child transmission, of the 12 babies born from HIV positive mothers, only 4 showed paraclinical data that suggested HIV infection.

The survey conducted on HIV prevalence among pregnant women showed 0.175% prevalence for Constanta County. The epidemiological data analysis showed that the probability of HIV infection among pregnant women broken down by ethnicity indicated a relative risk of 0.0012 in pregnant women from Romanian population and a 6, respectively 9 times higher risk in Roma population and Muslims (Muslim Roma, Turks, Tatars etc). The analysis of HIV associated risk factors among pregnant women indicated a relative risk of 1.052 for those with HIV positive partners, followed by pregnant women with partners at risk (86.4%) and commercial sex workers (60.9%).

Training:

4 training sessions were organized within the project, attended by 35 obstetrician-gynecologists, 25 nurses / midwives and 350 general practitioners or family doctors. The subjects of the courses included pre and post-test counseling, ante and postnatal care, obstetric case management, clinic and therapeutic case management, post-exposure prophylaxis, applying universal precautions concerning HIV transmission in medical care etc.

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