Elimination of Mother-to-Child Transmission of HIV, an experience from Oman

Background: The transmission of HIV from HIV-infected mother to her child is the most common route of HIV transmission in children. In 2009, HIV screening among pregnant women was introduced in Oman as part of antenatal care integrated into primary health care. We describe Oman's experience of implementing prevention of mother-to-child transmission (MTCT) of HIV program. Methods: A national HIV screening and counselling for pregnant women was implemented as a component of antenatal package of care at primary health care. Upon confirmation of a positive test, antiretroviral therapy (ART) is provided at tertiary or secondary care. Results: Cumulatively 424,077 pregnant women attended ANC during the period (July) 2009-2014 with high levels of ANC coverage >95% of pregnant woman had at least one ANC clinic visit; of those 98% of the pregnant women received counseling and tested for HIV. Ninety HIV positive cases were identified resulting in HIV sero-prevalence of 0.02% and 85 (94%) were age group 20-49 years. During the same period, 31 infant were born with HIV; the annual average for transmission rate was 39%; while the annual HIV newborn due to MTCT is 10 per 100,000 live births. Conclusions: Introduction of HIV testing and counseling services was very successful, however mother-to-child HIV transmission rate is still below the target, therefore the contributing barriers need to be identify and managed.