Circular No. 09/2021/TT-BYT stipulates the procedures, timing, and number of HIV tests for pregnant women; care and treatment for HIV-positive women during pregnancy, childbirth, breastfeeding, and measures to reduce mother-to-child transmission of HIV.

CIRCULAR

REGULATIONS ON PROCEDURES, TIMES, AND NUMBER OF HIV TESTS FOR PREGNANT WOMEN; CARE AND TREATMENT FOR HIV-INFECTED WOMEN DURING PREGNANCY, AT DELIVERY, AND WHILE BREASTFEEDING, AND MEASURES TO REDUCE HIV TRANSMISSION FROM MOTHER TO CHILD

Pursuant to the Law on Prevention and Control of Infection with Human Immunodeficiency Virus (HIV/AIDS) No. 64/2006/QH11 dated June 29, 2006; Law Amending and Supplementing Certain Provisions of the Law on Prevention and Control of Infection with Human Immunodeficiency Virus (HIV/AIDS) No. 71/2020/QH14 dated November 16, 2020; At the proposal of the Director of the Department of HIV/AIDS Prevention and Control under the Ministry of Health;

Pursuant to the Government's Decree No. 75/2017/NĐ-CP dated June 20, 2017 stipulating the functions, tasks, powers, and organizational structure of the Ministry of Health;

The Minister of Health issues this Circular stipulating procedures, times, and number of HIV tests for pregnant women; care and treatment for HIV-infected women during pregnancy, at delivery, while breastfeeding, and measures to reduce HIV transmission from mother to child.

This Circular stipulates procedures, times, and number of HIV tests for pregnant women whose HIV testing costs are covered by health insurance funds or state budget; care and treatment for HIV-infected women during pregnancy, at delivery, while breastfeeding, and measures to reduce HIV transmission from mother to child.

Article 1. Scope of Regulation

This Circular applies to medical examination and treatment facilities and other healthcare facilities providing services to pregnant women, mothers, children, and relevant agencies, organizations, and individuals.

Article 2. Applicability

Article 3. Procedures for HIV Testing for Pregnant Women

Procedures for HIV testing for pregnant women shall be carried out in accordance with the provisions of Circular No. 01/2015/TT-BYT dated February 27, 2015, issued by the Minister of Health guiding counseling on HIV/AIDS prevention and control at healthcare facilities, professional guidelines of the Ministry of Health, and the following contents:

1. Counseling for pregnant women before HIV testing on routes of HIV transmission, the necessity of knowing their HIV status, risks of HIV transmission to the child, and benefits of early antiretroviral therapy in reducing mother-to-child HIV transmission.

2. Indications for HIV testing for pregnant women shall be implemented in accordance with Article 4 of this Circular.

3. Performing HIV testing techniques for pregnant women.

4. Providing HIV test results to pregnant women. For pregnant women tested for HIV during labor and delivery, the HIV test results must be provided to the designated healthcare facility as soon as possible and not later than six hours from the time of sample receipt.

5. Counseling and post-test management for pregnant women:

a) In cases where pregnant women have a positive HIV test result: Counseling on mother-to-child HIV transmission prevention and immediate referral to antiretroviral therapy facilities;

b) In cases where pregnant women have a reactive HIV test result during labor and delivery, they must be counseled on immediate mother-to-child HIV transmission prevention with antiretroviral therapy for both mother and child, immediate referral for confirmatory HIV testing, and continued antiretroviral therapy for both mother and child until confirmatory results are available; if the mother's HIV test result is negative, antiretroviral therapy should be discontinued;

c) In cases where pregnant women have a negative HIV test result but engage in high-risk behavior for HIV infection: Counseling on HIV prevention and referral of pregnant women to facilities providing HIV prevention services.

c) In the case where pregnant women have a negative HIV test result and engage in high-risk behavior for HIV infection: Provide HIV prevention counseling and refer pregnant women to facilities providing services to prevent HIV transmission.

Article 4. Time and number of HIV tests for pregnant women

Pregnant women who are unaware of their HIV status and agree to undergo an HIV test shall be instructed to have an HIV test during regular prenatal check-ups or at childbirth according to the national guidelines on reproductive health services for pregnant women issued by the Ministry of Health, specifically as follows:

1. The first HIV test should be conducted as early as possible.

2. The second HIV test shall be conducted for cases with high-risk behavior as stipulated in Clause 6, Article 2 of the Law on Prevention and Control of HIV/AIDS No. 64/2006/QH11, specifically as follows:

a) Engaging in high-risk behavior within three months prior to the first HIV test;

b) Engaging in high-risk behavior after the first HIV test.

Article 5. Care and treatment for HIV-positive women during pregnancy, childbirth, and breastfeeding; measures to reduce mother-to-child transmission of HIV for pregnant women

1. Care and treatment for HIV-positive women during pregnancy shall be carried out in accordance with the professional guidelines on HIV/AIDS treatment and care issued by the Ministry of Health.

2. Measures to reduce mother-to-child transmission of HIV for pregnant women shall be implemented according to the professional guidelines of the Ministry of Health on the implementation of mother-to-child HIV transmission prevention.

Article 6. Effectiveness

This Circular takes effect from August 15, 2021.

Article 7. Reference Provisions

In case the referenced documents in this Circular are replaced or amended, they shall be applied according to the replacement, amendment, or supplementation documents.

Article 8. Responsibility for Implementation

1. The HIV/AIDS Prevention and Control Department shall take the lead and coordinate with units under the Ministry to organize the implementation, inspection, and supervision of this Circular throughout the country.

2. Provincial Departments of Health under centrally governed cities shall be responsible for directing and guiding the organization of implementation, inspection, and supervision of this Circular for healthcare facilities under their jurisdiction.

3. The Director of the Ministry's Office, the Inspector General of the Ministry, the Director of the HIV/AIDS Prevention and Control Department, the Heads of Departments, Directors of Bureaus, and General Directors of the Ministry of Health, the Heads of subordinate agencies and units of the Ministry, the Directors of Provincial Departments of Health under centrally governed cities, the Heads of health agencies of ministries and sectors, and related organizations and individuals shall be responsible for implementing this Circular. Any difficulties encountered during implementation shall be promptly reported to the Ministry of Health (HIV/AIDS Prevention and Control Department) for research and resolution.

During implementation, any difficulties shall be promptly reported to the Ministry of Health (HIV/AIDS Prevention and Control Department) for research and resolution./.