Abstract

The operational research process of the Latin American and Caribbean initiative for the integration of prenatal care with the testing and treatment of HIV and syphilis

A. Castro¹, C. Bautista², E. Pérez³, J. Bayona⁴, J. Calderón<sup>5

1</sup>Harvard Medical School, Global Health and Social Medicine, Boston, United States, ²COPRESIDA, Santo Domingo, Dominican Republic, ³Centro Nacional de Investigaciones en Salud Materno Infantil, Santo Domingo, Dominican Republic, ⁴Partners In Health - Peru, Lima, Peru, ⁵Ministry of Health - Peru, Lima, Peru

Issues: As a component of the Latin America and Caribbean Initiative for the Integration of Prenatal Care with the Testing and Treatment of HIV and Syphilis (ILAP), we use operational research (OR) to guide the implementation of the integration of prenatal care with the testing and treatment of HIV and syphilis in Peru and the Dominican Republic. ILAP brings together the expertise of national AIDS programs, public health decision-makers, clinicians and international institutions (UNICEF, UNAIDS, PAHO) with rigorous OR (Harvard Medical School); it works in coordination with the Regional Initiative for the Elimination of Mother-to-Child Transmission of HIV and Congenial Syphilis in Latin America and the Caribbean.
Description: The OR combines medical anthropology, epidemiology, and health policy analysis to understand: the organizational structure of the national programs on AIDS and prenatal care; health services monitoring systems; prevention and treatment protocols; structure of the national laboratory network; training programs on testing and treatment for HIV and syphilis; allocation of resources; insurance and cost-recovery mechanisms. This situation analysis aims to identify strengths and weaknesses at the national and local levels.
Lessons learned: Based on the evaluation of the research findings, a team from Peru and the Dominican Republic delineated a detailed plan of action for each country aimed at universalizing routine testing and treatment of HIV and syphilis during pregnancy and to measure the impact of these interventions. Although each plan of action was country-specific, their collaborative work through ILAP allowed the sharing of implementation strategies and problem solving.
Next steps: Implementation plans based on rigorous OR can improve early diagnosis and timely treatment of HIV and syphilis in pregnant women, decrease MTCT of HIV and congenital syphilis, and prevent loss to follow up of women and children exposed to HIV and syphilis. The same mechanisms can be used to prevent and treat other STIs.