In 1987, a prenatal screening program for HIV was started at the Puerto Rico Medical Center. They were the first prenatal tests for the virus within the jurisdiction of the United States.
Dr. Carmen Zorrilla, professor at the Medical Sciences Campus and researcher of the Novavax vaccine in Puerto Rico. Photo: Provided to the Journal of Medicine and Public Health.
In the 1980s, the acronym HIV they were bad sounding. Something like having death tattooed on your forehead because the monster called AIDS devastated everything in its path. Not even the children had mercy.
For example, in 1997, a pregnant woman carrying the Human Immunodeficiency Virus had a 25 percent chance of transmitting it to her offspring. Even more exact: one in four babies was born with the virus.
However, that cyclone of despair is a thing of the past. When a prenatal screening program was started in 1987 for the HIV in the captive population of the University Hospital, in the Medical Center of Puerto Rico, as a result of an anonymous survey carried out among pregnant women that showed that 1 of every 71 samples (1.8%) were positive at HIVthe door was opening for the early identification of the virus in pregnant women, which made it possible to address it with timely and adequate treatment.
“Access to clinical research, and to multiple comprehensive care strategies, has been responsible for the reduction of perinatal transmission of HIV to zero since 1997, with the exception of one case in 2002,” cites the study by the University of Puerto Rico (UPR) School of Medicine, led by Professor of Obstetrics and Gynecology, Dr. Carmen D. Zorrilla.
Merit is worth a lot because it was like winning a game that was once considered an invincible enemy, especially when looking closely at the statistics that placed Puerto Rico among the first 5 jurisdictions in the United States with the highest rates of AIDS cases by population in men, women and children. Incidentally, in 1985, 11.3% of AIDS cases in Puerto Rico were reported in women, figures that increased to 24.7% in 1997.
Due to the fruit that she carried in her womb, the search for strategies that could tackle the problem, to prevent it from becoming more difficult to manage, became an obligatory subject. It was then that those prenatal screening tests for the HIV.
In this way, the prenatal tests for the virus that were derived from that initiative were the first within the jurisdiction of the United States. That is to say, the intervention developed by a scientific team through the Center for Maternal and Child Studies (CEMI) and the GAMMA project of the University of Puerto Rico School of Medicine, marked the way for the early identification of pregnant women living with the HIV.
“Because the transmission of the virus occurs during pregnancy and childbirth, we have been able to identify the carrier woman during pregnancy and offer her treatment throughout the entire process and postnatal for the baby,” the investigation reveals. .
Some time later, the GAMMA Project of the UPR was chosen to participate in the pilot test with ACTG 076. This particular study showed that giving prophylaxis with Zidovudine (AZT) to pregnant women and carriers of HIV reduced the probability of perinatal infection. As early as 1994, the Puerto Rico Department of Health offered the drug to all pregnant women identified with the HIV during prenatal care, being the country one of the first jurisdictions to implement a public policy of this kind.
“This has been the result of multiple strategies involving an intervention, the dissemination of results, and the implementation of public health policies and medical interventions, such as: advice and tests of HIV during prenatal care; access to comprehensive care that includes antiretroviral therapy during pregnancy, childbirth and postpartum; access to virological and immunological laboratory tests; access to prophylaxis as prevention of opportunistic infections (OIs); access to baby formula; access to cesarean deliveries when necessary; provide medical, psychological and social services, as well as provide education and support; among other strategies”, highlights the report by the UPR research team.
Specifically, the CEMI presents statistics of its work for a period of 20 years, during which time it has evaluated approximately 1,541 women living with HIV, of which 612 are in active monitoring. Meanwhile, in a period that includes the last 10 years, almost 400 pregnant women living with the HIV and only one child was born with the virus.
“Without any interventions, at least 26% of these children would have been infected,” the study highlights. “Therefore, the interventions were successful in preventing the infection of 103 babies during the last 10 years.”
In fact, the test of HIV during pregnancy was endorsed by the Centers for Disease Control (CDC) and many years later, in 2006, they accepted the recommendations to carry out the exams in all health centers as part of routine tests in pregnant women.
Those procedures that have been experimented with in our country, with Puerto Rican mothers, have given excellent results and universal fruits. In other words, Puerto Rico has been part of this history and has benefited from these life-saving advances, as have many carriers of the HIV Worldwide.