Strengthened surveillance and prevention of mother-to-child transmission of HIV, syphilis and hepatitis B towards triple elimination by 2030

Fig. 01. Registration, recording and reporting pregnant woman sentinel surveillance ANC data. Photo credit: Puskesmas Sememi-Surabaya

Written by Kemmy A Purnamawati

Surveillance of HIV and sexually transmitted infections (STIs) in key populations has been implemented in Indonesia since 2009. Trends in HIV and syphilis prevalence in key populations consisting of female sex workers (FSW), men who have sex with men (MSM), transgenders, people who inject drugs (PWID), correctional inmates and FSW customers, can be monitored through this data.

Routine integrated behavior and biological surveys (IBBS) in 2007 and 2015, conducted by the Ministry of Health (MoH), indicated increased prevalence of HIV and STIs in some of the key populations, particularly among MSM and FSW. Between 2007 and 2015, the prevalence increased from 8% to 32% among MSM and 10% to 13% among FSW. In addition, only 40% of FSW and 60% of MSM reported to always use a condom (2015). Therefore, the risk of transmission to the general population is increasing and needs to be monitored and prevented.

One recommendation of the HIV-AIDS and STI country review in 2020 was for Indonesia to initiate a sentinel survey of ANC for pregnant women to monitor HIV, syphilis and hepatitis B prevalence in woman attending ANC. WHO assisted the MoH in establishing the survey by developing the technical guideline and related tools. WHO was also engaged in the planning, implementation, and monitoring of the surveillance, including on the ground at the surveillance sites.

During October-December 2021, data was collected from 400 pregnant women in 68 cities and districts, including Surabaya City in East Java Province. The sites in Surabaya were Sememi and Benowo Primary Health Centers.

Fig. 02. HIV, STI and hepatitis B screening among pregnant women Photo credit: Puskesmas Sememi-Surabaya

MoH and WHO monitored the implementation in Surabaya City. The service flow, service delivery and recording-reporting were monitored. The monitoring suggested that most of the implementation of the survey was in line with the guidelines. However, improvements were needed in closer monitoring of mother and child pairs – data of the babies should also be recorded along with data of the mothers.

The data are currently being analyzed, and the results will be published. Gradually, other cities and districts, which are not part of the current 68 cities and districts, will conduct a similar sentinel survey annually. The data shall be used to inform further planning and actions toward local and national efforts on triple elimination.

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