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Principles

Linkages of RH & HIV Programs Towards P/E MTCT Abbas Sedaghat MD.MPH National HIV/STI Program Manager CDC – MOH - IRAN. Principles. Prevention of HIV/STI among women in reproductive ages Prevention of unwanted pregnancy among HIV+ women Prevention of HIV transmission

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Principles

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  1. Linkages of RH & HIV Programs TowardsP/E MTCTAbbas Sedaghat MD.MPHNational HIV/STI Program ManagerCDC – MOH - IRAN

  2. Principles • Prevention of HIV/STI among women in reproductive ages • Prevention of unwanted pregnancy among HIV+ women • Prevention of HIV transmission from mother to child

  3. Principles • Scale up HIV/STI Surveillance System among pregnant women and newborns • Procurement of needed ARV for pregnant women and newborns

  4. Areas of interventions“4Prongs” • Pre Marriage Period • Pregnancy Period • Delivery Period • After delivery Period “ On time HIV diagnosis ” “ On time initiation of ART ” “ Retain on treatment ”

  5. More Focus on • Promotion of reproductive health • More involvement of private sector • More involvement of men in reproductive cares • Scale up the referral system

  6. Prong 1 “Pre Marriage Period” • HIV/STI awareness raising Universities, Schools, Mass media, Health facilities, Pre marriage Counseling Centers, • Prevention and Harm Reduction services Health facilities Counseling Centers for Vulnerable Women

  7. Prong 2 “Pregnancy Period” • HIV/STI awareness raising Maternal Care Health facilities, Pre marriage Counseling Centers, • Prevention and Harm Reduction services HIV/STI management and treatment, Dual protection, Partner notification, ARV prophylaxis and treatment Safe abortion , Referral system

  8. Prong 3 “Delivery Period” • Prevention services HIV/STI management and treatment Safe delivery / Cesarean Section Standard precaution Partner notification Referral system

  9. Prong 4 “After delivery Period” • Prevention services ARV prophylaxis and treatment of newborns HIV assessment / EID Standard precaution Formula feeding Referral system

  10. Services Facilities • Health facilities in national PHC system • Maternal health facilities • Neonatal health facilities • VCT centers • Private sectors • Positive clubs ( 17 ) • Counseling Centers for Vulnerable Women ( 30 )

  11. First step • The operational guidelines, reporting system forms and related workshops were developed • First step of program has been conducted since March 2014 • 16 hot spot areas have been included in first step at country wide • 150.000 pregnant women is expected to be under coverage of PMTCT program in first phase

  12. New approaches • Effective PITC (Provider Initiation Testing ) Opt–out approach • Continues ART (among pregnant women) B+ Option

  13. Challanges • Stigma and Discrimination in General Population • Stigma and Discrimination in Health Facilities • Social barrier for awareness raising programs • Weak collaboration from private sector • Weak involvement of mass media • Insufficient support of policy makers • Adolescents as the main target group

  14. MILAD Tower , Tehran - IRAN

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