Preventing mother-to-child transmission of HIV in Vietnam: an assessment of progress and future directions.

Preliminary to the development a new program supporting perinatal HIV prevention, this assessment was conducted to evaluate Vietnam's national prevention of mother-to-child HIV transmission (PMTCT) program by estimating HIV prevalence among prenatal women and analyzing the healthcare system capacity to deliver services. In 2002-03, a technical team reviewed existing national and local surveillance and program data and conducted on-site interviews and observations at maternal-child health (MCH) programs in the seven provinces with highest HIV rates. The team found that despite high (85%) prenatal service utilization and widespread availability of HIV testing and dissemination of prevention protocols, few HIV-infected mothers were identified in time to allow effective perinatal HIV prevention. Program deficits clustered around the general areas of provider misunderstanding of occupational HIV risk and MTCT, impractical PMTCT policies, and practices hampering effective use of prevention and treatment protocols. Existing problems were significant but modifiable, and will require implementation of practical and appropriate guidelines, enhanced clinical and laboratory capacity, and continued program management and monitoring.