The Argentine-Maltese Aid Program for the Prevention of Perinatal AIDS, implemented in nine public hospitals in Buenos Aires, Argentina, has reduced the rate of mother-to-child transmission of HIV by nearly 90 percent. Perinatal transmission is the cause of 7 percent of HIV/AIDS cases in this Southern Cone country of 37 million. Dr. Mar a Sarubbi, a PPPA physician, said it was possible the program, supported by the Sovereign Order of the Knights of Malta (KOM), could reduce the perinatal infection rate from 25 percent to 2.7 percent.

All pregnant women attending prenatal visits in the hospitals or coming in for other reasons are tested for HIV/AIDS under the program, Sarubbi said. "The women whose results come back negative receive HIV/AIDS prevention outreach, while those who test positive are enrolled in the program to begin to receive treatment," she said. Sarubbi explained that although the earlier an HIV-positive mother begins treatment the better, the absolute cut-off date is when she is seven months pregnant. Beyond that limit, she said, the possibility of preventing perinatal infection sharply declines.

Of the 144 women who enrolled in the program, half were unaware of their HIV-positive status until they were tested in the hospitals, said Sarubbi. The National AIDS Program provides AIDS tests and antiretrovirals, as well as supplies of infant formula so that infected mothers do not breast-feed their babies -- one of the main routes of mother-to-child HIV transmission. However, the test results, drugs and formula do not always arrive on time, said Sarubbi, who underlined that timely provision of the assistance and essential resources is key to a successful program.

"[KOM's support] 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," Sarubbi explained. C-sections for program participants have been reduced 17 percent. Most women testing positive for HIV in Buenos Aires are low-income and face difficulties with health care access, said Sarubbi. In addition, many have unwanted pregnancies, and are unaware that they are infected, or that their young children test HIV-positive. "Around 20 percent of the pregnant women who come to the hospital to give birth have never received any prenatal controls," she added.

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