Antenatal Education to Support Triple Elimination Program: A Systematic Literature Review


Ni Komang Sulyastini , I Made Ady Wirawan






Vol. 9 No. 8 (2023): August


Antenatal education, Hepatitis B, HIV, Syphilis, Triple elimination



How to Cite

Sulyastini, N. K., & Wirawan, I. M. A. (2023). Antenatal Education to Support Triple Elimination Program: A Systematic Literature Review. Jurnal Penelitian Pendidikan IPA, 9(8), 474–485.


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This study aims to describe cases of transmission of HIV, hepatitis B and syphilis from mother to child and how the role of antenatal education in supporting the triple elimination program. This research was conducted using a systematic literature review approach. Researchers collected data from research articles that have been published in Scopus indexed international electronic journals. Data was collected using several keywords with the Google search engine and portals providing articles from Scopus indexed journals, such as ScienceDirect, MDPI, and NCBI. The data collected was then analyzed by researchers using an interactive data analysis model. The results of the analysis found that the implementation of triple elimination has been successfully carried out in various countries, although there are still various obstacles that must be faced in its implementation. Furthermore, several studies have also found that antenatal education has an important role in reducing the risk of transmission of HIV, hepatitis B and syphilis from mother to child. So, it can be concluded that antenatal education is crucial to provide in order to support the triple elimination program to prevent cases of transmission of HIV, hepatitis B and syphilis from mother to child


Abbamonte, J. M., Ramlagan, S., Lee, T. K., Cristofari, N. V, Weiss, S. M., Peltzer, K., Sifunda, S., & Jones, D. L. (2020). Stigma interdependence among pregnant HIV-infected couples in a cluster randomized controlled trial from rural South Africa. Social Science & Medicine, 253, 112940.

Adawiyah, R. al, Boettiger, D., Applegate, T. L., Probandari, A., Marthias, T., Guy, R., & Wiseman, V. (2022). Supply-side readiness to deliver HIV testing and treatment services in Indonesia: Going the last mile to eliminate mother-to-child transmission of HIV. PLOS Global Public Health, 2(8), e0000845.

Agabu, A., Baughman, A. L., Fischer-Walker, C., de Klerk, M., Mutenda, N., Rusberg, F., Diergaardt, D., Pentikainen, N., Sawadogo, S., & Agolory, S. (2020). National-level effectiveness of ART to prevent early mother to child transmission of HIV in Namibia. PloS One, 15(11), e0233341.

Biadgo, B., Hassen, A., Getaneh, M., Tesfa, H., Jaleta, K. N., Eshetu, T., Kasew, D., & Melku, M. (2019). Syphilis and human immunodeficiency virus infections among pregnant women attending antenatal care clinic of Gondar family guidance association, Northwest Ethiopia: implication for prevention of mother to child transmission. Reproductive Health, 16, 1–8.

Cerveny, L., Murthi, P., & Staud, F. (2021). HIV in pregnancy: Mother-to-child transmission, pharmacotherapy, and toxicity. Biochimica et Biophysica Acta (BBA)-Molecular Basis of Disease, 1867(10), 166206.

Chilaka, V. N., & Konje, J. C. (2021). HIV in pregnancy–An update. European Journal of Obstetrics & Gynecology and Reproductive Biology, 256, 484–491.

Cohn, J., Owiredu, M. N., Taylor, M. M., Easterbrook, P., Lesi, O., Francoise, B., Broyles, L. N., Mushavi, A., Van Holten, J., & Ngugi, C. (2021). Eliminating mother-to-child transmission of human immunodeficiency virus, syphilis and hepatitis B in sub-Saharan Africa. Bulletin of the World Health Organization, 99(4), 287.

Delzer, M. E., Kkonde, A., & McAdams, R. M. (2021). Viewpoints of pregnant mothers and community health workers on antenatal care in Lweza village, Uganda. Plos One, 16(2), e0246926.

Elgalib, A., Lau, R., Al-Habsi, Z., Shah, S., Al-Rawahi, B., Memish, Z. A., Lee, S. S., & Al-Abri, S. (2023). Elimination of mother-to-child transmission of HIV, syphilis and viral hepatitis B: A call for renewed global focus. International Journal of Infectious Diseases, 127, 33–35.

Fatimah, M. (2020). Determinants of Pregnant Women Participation on Triple Elimination of HIV, Syphilis, and Hepatitis B, in Semarang. Journal of Health Promotion and Behavior, 5(2), 123–134.

Gupta, A., Verma, A., Kashyap, M., & Gautam, P. (2020). ART in prevention of mother-to-child transmission of HIV. The Journal of Obstetrics and Gynecology of India, 70, 18–22.

Hakawi, A., & Mokhbat, J. (2022). The Current Challenges Affecting the Quality of Care of HIV/AIDS in the Middle East: Perspectives from Local Experts and Future Directions. Journal of Infection and Public Health.

Jaiswal, A. K., Jamal, S. B., Gabriel Rodrigues Gomes, L., Profeta, R., Sales-Campos, H., Oliveira, C. J. F., Figueira Aburjaile, F., Tiwari, S., Barh, D., & Silva, M. V. da. (2022). Neuroinformatics Insights towards Multiple Neurosyphilis Complications. Venereology, 1(1), 135–160.

Kempton, J., Hill, A., Levi, J. A., Heath, K., & Pozniak, A. (2019). Most new HIV infections, vertical transmissions and AIDS-related deaths occur in lower-prevalence countries. Journal of Virus Eradication, 5(2), 92–101.

Lalhruaimawii, I., Danturulu, M. V., Rai, S., Chandrashekar, U. K., & Radhakrishnan, R. (2022). Determinants of stigma faced by people living with Human Immunodeficiency Virus: A narrative review from past and present scenario in India. Clinical Epidemiology and Global Health, 101117.

Lawson, R. M. (2022). HIV and Other Sexually Transmitted Infections: Screening Recommendations. The Journal for Nurse Practitioners, 18(1), 40–44.

Liu, D., Liu, Y., Ni, J., Li, H., Zeng, L., Zhang, C., Zhang, L., Yu, Q., Wu, B., & Zhang, L. (2022). Hepatitis B Infection Among Pregnant Women in China: A Systematic Review and Meta-Analysis. Frontiers in Public Health, 10.

Lubega, P., Nakakawa, F., Narciso, G., Newman, C., Kaaya, A. N., Kityo, C., & Tumuhimbise, G. A. (2021). Body and mind: Experimental evidence from women living with HIV. Journal of Development Economics, 150, 102613.

Moyo, I., & Mavhandu-Mudzusi, A. H. (2021). A model for enhancing prevention of mother to child HIV transmission in a low resource setting. International Journal of Africa Nursing Sciences, 15, 100359.

Muyunda, B., Musonda, P., Mee, P., Todd, J., & Michelo, C. (2020). Effectiveness of lifelong ART (Option B+) in the prevention of mother-to-child transmission of HIV programme in Zambia: observations based on routinely collected health data. Frontiers in Public Health, 7, 401.

Oladunni, A. A., Sina-Odunsi, A. B., Nuga, B. B., Adebisi, Y. A., Bolarinwa, O. A., Adeola, A. A., & Lucero-Prisno, D. E. (2021). Psychosocial factors of stigma and relationship to healthcare services among adolescents living with HIV/AIDS in Kano state, Nigeria. Heliyon, 7(4).

Omonaiye, O., Kusljic, S., Nicholson, P., Mohebbi, M., & Manias, E. (2019). Post Option B+ implementation programme in Nigeria: Determinants of adherence of antiretroviral therapy among pregnant women with HIV. International Journal of Infectious Diseases, 81, 225–230.

Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., Shamseer, L., Tetzlaff, J. M., Akl, E. A., & Brennan, S. E. (2021). The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. International Journal of Surgery, 88, 105906.

Peliganga, L. B., Horta, M. A. P., & Lewis-Ximenez, L. L. (2022). Enduring Challenges despite Progress in Preventing Mother-to-Child Transmission of Hepatitis B Virus in Angola. Pathogens, 11(2), 225.

Pendse, R., Gupta, S., Yu, D., & Sarkar, S. (2016). HIV/AIDS in the South-East Asia region: progress and challenges. Journal of Virus Eradication, 2, 1–6.

Posuwan, N., Wanlapakorn, N., Sintusek, P., Wasitthankasem, R., Poovorawan, K., Vongpunsawad, S., & Poovorawan, Y. (2020). Towards the elimination of viral hepatitis in Thailand by the year 2030. Journal of Virus Eradication, 6(3), 100003. org/

Rizzo, G. E. M., Cabibbo, G., & Craxì, A. (2022). Hepatitis B virus-associated hepatocellular carcinoma. Viruses, 14(5), 986.

Rudi, A., Haryanti, Y., Masan, L., Maretalinia, M., & Yulianto, A. (2020). The Determinants of Sexually Transmitted Infections (STIs) among Female Sex Workers (FSWs) in Indonesia: The Literature Review. Journal of Health Epidemiology and Communicable Diseases, 6(1), 15–24.

Sausen, D. G., Shechter, O., Bietsch, W., Shi, Z., Miller, S. M., Gallo, E. S., Dahari, H., & Borenstein, R. (2022). Hepatitis B and Hepatitis D Viruses: A Comprehensive Update with an Immunological Focus. International Journal of Molecular Sciences, 23(24), 15973.

Schenkel, K., & Gupta, R. (2021). Molecular probes and detection of sexually transmitted infections. In Methods in Microbiology (Vol. 48, pp. 111–133). Elsevier.

Sebastião, C. S., Neto, Z., Jandondo, D., Mirandela, M., Morais, J., & Brito, M. (2020). HIV, hepatitis B virus, hepatitis C virus, and syphilis among pregnant women attending antenatal care in Luanda, Angola: Seroprevalence and risk factors. Journal of Medical Virology, 92(12), 3265–3270.

Seo, K.-I., Jo, J.-C., Kim, D.-J., Jeong, J.-Y., Lee, S., & Lee, H.-S. (2022). Chronic Hepatitis B Viral Activity Enough to Take Antiviral Drug Could Predict the Survival Rate in Malignant Lymphoma. Viruses, 14(9), 1943.

Shava, E., Moyo, S., Zash, R., Diseko, M., Dintwa, E. N., Mupfumi, L., Mabuta, J., Mayondi, G., Chen, J. Y., & Lockman, S. (2019). High rates of adverse birth outcomes in HIV and syphilis co-infected women in Botswana. Journal of Acquired Immune Deficiency Syndromes (1999), 81(5), e135.

Siregar, K. N., Hanifah, L., Rikawarastuti, & Wahyuniar, L. (2021). Prevention of HIV Transmission from Mother to Child: Challenges to the Successful Program Implementation and Practice in Indonesia. Journal of the International Association of Providers of AIDS Care (JIAPAC), 20, 23259582211040700.

Smith, M. H., Vargo, R. J., Bilodeau, E. A., Anderson, K. M., Trzcinska, A., Canterbury, C. R., Fantasia, J. E., & Rawal, Y. B. (2021). Oral manifestations of syphilis: a review of the clinical and histopathologic characteristics of a reemerging entity with report of 19 new cases. Head and Neck Pathology, 1–9.

Snyder, H. (2019). Literature review as a research methodology: An overview and guidelines. Journal of Business Research, 104, 333–339.

Tepe-Mensah, M., Osarfo, J., Agbeno, E. K., & Ampofo, G. D. (2022). Willingness to Test for Human Immunodeficiency Virus (HIV) Infection among First-Year Students of a Public University in the Volta Region of Ghana. Venereology, 1(2), 212–222.

Tiecco, G., Degli Antoni, M., Storti, S., Marchese, V., Focà , E., Torti, C., Castelli, F., & Quiros-Roldan, E. (2021). A 2021 update on syphilis: Taking stock from pathogenesis to vaccines. Pathogens, 10(11), 1364.

Tu, T., Block, J. M., Wang, S., Cohen, C., & Douglas, M. W. (2020). The lived experience of chronic hepatitis B: a broader view of its impacts and why we need a cure. Viruses, 12(5), 515.

Vargas, L., Bastos, F., Guimarães, A., Amaral, S., Fausto, T., Arriaga, M., Sarno, M., & Brites, C. (2020). Seroprevalence and factors associated with Human Immunodeficiency virus, Human T lymphotropic virus and Hepatitis B/C infections in parturient women of Salvador–Bahia, Brazil. Brazilian Journal of Infectious Diseases, 24, 279–287.

Wang, X., Wang, Q., Wang, C., Zhang, T., Li, Z., Ma, Z., & Wang, A. (2021). Prevention of Mother-To-Child Transmission of HIV—China, 2011–2020. China CDC Weekly, 3(48), 1018.

Watt, M. H., Knettel, B. A., Knippler, E. T., Kisigo, G., Ngocho, J. S., Renju, J., Rogathi, J., Sao, S. S., Minja, L., & Osaki, H. (2020). The development of Maisha, a video-assisted counseling intervention to address HIV stigma at entry into antenatal care in Tanzania. Evaluation and Program Planning, 83, 101859.

Woodring, J., Ishikawa, N., Nagai, M., Malarski, M., Takashima, Y., Sobel, H., & Lo, Y.-R. (2017). Integrating HIV, hepatitis B and syphilis screening and treatment through the Maternal, Newborn and Child Health platform to reach global elimination targets. Western Pacific Surveillance and Response Journal: WPSAR, 8(4), 1.

World Health Organization. (2018). Triple elimination of mother to child trans-mission of HIV, Hepatitis B and sy-philis.

Wu, Y., Gao, J., Qin, J., He, J., Wang, A., Wang, H., Du, Q., Fang, J., Sheng, X., & Wang, R. (2019). Mother-to-child transmission prevention of human immunodeficiency virus, syphilis and hepatitis B virus. Women and Birth, 32(6), 570–578.

Yendewa, G. A., Lakoh, S., Yendewa, S. A., Bangura, K., Lawrence, H., Patiño, L., Jiba, D. F., Vandy, A. O., Murray, M. J. S., & Massaquoi, S. P. (2021). Prevalence of hepatitis B surface antigen and serological markers of other endemic infections in HIV-infected children, adolescents and pregnant women in Sierra Leone: A cross-sectional study. International Journal of Infectious Diseases, 102, 45–52.

Zhang, C., Ren, Q., & Chang, W. (2020). Epidemiological features and risk factors for acquiring hepatitis B, hepatitis C, and syphilis in HIV-infected patients in Shaanxi Province, Northwest China. International Journal of Environmental Research and Public Health, 17(6), 1990.

Zheng, H., Walsh, N., Lesi, O., & Cui, F. (2022). New progress towards elimination of mother-to-child transmission of hepatitis B virus in China. Hepatology International, 1–9.

Zhong, S., Ou, Y., Zhang, F., Lin, Z., Huang, R., Nong, A., Wu, Z., Liang, H., Qin, C., & Wei, Q. (2022). Prevalence trends and risk factors associated with HIV, syphilis, and hepatitis C virus among pregnant women in Southwest China, 2009–2018. AIDS Research and Therapy, 19(1), 1–13.

Zijenah, L. S., Bandason, T., Bara, W., Chipiti, M. M., & Katzenstein, D. A. (2021). Mother-to-child transmission of HIV-1 and infant mortality in the first six months of life, in the era of Option B Plus combination antiretroviral therapy. International Journal of Infectious Diseases, 109, 92–98.

Author Biographies

Ni Komang Sulyastini, Universitas Pendidikan Ganesha

I Made Ady Wirawan, Fakultas Kedokteran Universitas Udayana, Denpasar, Bali


Copyright (c) 2023 Ni Komang Sulyastini, I Made Ady Wirawan

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