Reducing infant HIV exposure, is critical to reducing the paediatric HIV case rate increasing ART access is critical to reduce percent MTCT. In multiple regression, HEI and ART access accounts for 83% of the case rate, with HEI making the most contribution (coef. In linear regression models, ART access alone explains only 17% of the case rate while HEI alone explains 81% of the case rate. In contrast, SEM demonstrated that the case rate was driven by the number of HIV exposed infants (HEI) i.e. Structural equation modelling (SEM) and linear regression analysis demonstrated that ART access protects against percent MTCT ( p<0.001) in simple linear regression it is 53% protective against percent MTCT. Additionally, Global Plan priority countries have limited data on key SRH indicators such as unmet need for family planning, with variable coverage of antenatal care, HIV testing and triple antiretroviral therapy (ART) and very limited contact tracing. Although by 2016 EMTCT-validated countries and Global Plan priority countries had adopted a public health approach to HIV prevention, recommending lifelong antiretroviral therapy (ART) for all HIV-positive pregnant and lactating women, EMCT-validated countries had also included contact tracing such as assisted partner notification, and had integrated maternal and child health (MCH) and sexual and reproductive health (SRH) services, with services for HIV infection, sexually transmitted infections, and viral hepatitis. ResultsĮMTCT-validated countries have lower HIV prevalence, less breastfeeding, fewer challenges around leadership, governance within the health sector or country, infrastructure and service delivery compared with Global Plan priority countries. Additionally, structural equation modelling (SEM) and linear regression were used to explain associations between infant HIV exposure, access to antiretroviral therapy and two outcomes: (i) percent MTCT and (iii) number of new paediatric HIV infections per 100 000 live births (paediatric HIV case rate). We applied three theories (the World Health Organisation’s building blocks to strengthen health systems, van Olmen’s Health System Dynamics framework and Baral’s socio-ecological model for HIV risk) to understand and explain the differences between EMTCT-validated and non-validated countries. Additionally, key global experts working on EMTCT were contacted to obtain clarification on published data. Data representing only one clinic, hospital or region were excluded. MethodsĪ literature review, using PubMed, Science direct and the google search engine was conducted to obtain global and national-level information on current HIV-related context and health system characteristics of the first four EMTCT-validated countries and the 21 SSA Global Plan priority countries. We consider what drives vertical transmission of HIV (MTCT) in the 21 SSA Global Plan priority countries. This paper synthesises the characteristics of the first four countries validated for EMTCT, and of the 21 Global Plan priority countries located in Sub-Saharan Africa (SSA). By 2019, no Global Plan priority country had achieved EMTCT however, 11 non-priority countries had.
It prioritises 22 countries where 90% of the world’s HIV-positive pregnant women live and aims to eliminate vertical transmission of HIV (EMTCT) and to keep mothers alive. In 2011 Moscow Union of “International Designers” awarded Angela a DIPLOMA for great achievements and contributions in the development of type design art, in 20 she was awarded Diplomas by the Ministry of Culture of Armenia for significant input in the development of Armenian type design art.The 2016 ‘Start Free, Stay Free, AIDS Free’ global agenda, builds on the 2011-2015 ‘Global Plan’. Since 2007 she has been a member of the GRANSHAN organizing committee and since 2013 she has been a member of the jury board of Annual International Type Design competition GRANSHAN. Her fonts have been displayed at exhibitions in Munich (Germany), Yerevan (Armenia), Hong Kong, Bangkok (Thailand), Moscow (Russia), Alexandria (Egypt). Angela’s fonts were awarded prizes at International Type Design Competitions GRANSHAN in 20. Since 2007 she has been working for the National Book Chamber of Armenia, the Department of Creating and Saving Armenian Fonts as a chief specialist and since then has been involved in designing typefaces. From 2000 to 2006 she worked at the Yerevan Juridical-Economical University as a lecturer of English. Angela Poghosova is a type designer, an interpreter and a translator who lives and works in Yerevan, Armenia.
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