Progress in prevention of mother-to-child transmission of HIV-1 in Zhejiang province, China, 2007-2013

This is a retrospective study based on surveillance of Human Immunodeficiency Virus type-1 (HIV-1) positive pregnant women and their children in China's Zhejiang Province. HIV counseling and testing, mother and infant characteristics, and outcomes are reported here. This study compares two principal periods, the period from 2007-2009 and the period from 2010 to 2013. The average rate of HIV counseling among pregnant women rose from 84.87% during the earlier period to 99.08% during the latter period. And the rate of HIV testing also rose significantly, from 80.60% to 98.58%. The HIV-1 prevalence among pregnant women increased slightly, from 0.01% to 0.02%. Over 70% of infected women were migrants. Half of these HIV-1 positive pregnant women were 20-30 years old. Significant differences in the characteristics of HIV-1 positive pregnant women were observed with time. The proportion of women who were employed increased dramatically from an average of 15.03% during 2007-2009 to an average of 31.34% during 2010-2013 and the proportion of women who had completed high school education increased from 0.52% to 6.51%. During 2007-2009, an average of 3.11% of these women was diagnosed before their pregnancies. During 2010-2013, this average reached to 32.53%. Sexual contact remained the primary route of transmission route during both periods, accounting for half of the infections. The proportion of women who had acquired HIV by blood transfusion declined noticeably. The proportion of mothers and children with antiretroviral therapy increased considerably over time. The overall mother-to-child transmission rate was found to be 7.14%. Although some progress has been made, further work should be performed, fostering early identification and timely therapy. Particular attention should be paid to health care of migrants.