Abstract
Since 1994, the availability of increasingly effective antiretroviral drugs for both the prevention of perinatal human immunodeficiency virus (HIV) transmission and maternal treatment has resulted in a greater emphasis on prenatal HIV testing and substantial increases in prenatal testing rates. In 2000, preliminary data indicated that 766 (93%) of 824 HIV-infected women in 25 states knew their HIV status before delivery (CDC, unpublished data, 2002). However, an estimated 280-370 perinatal HIV transmissions continue to occur in the United States each year. The primary strategy to prevent perinatal HIV transmission is to maximize prenatal HIV testing of pregnant women. States and Canadian provinces have implemented three different prenatal HIV-testing approaches. To assess their effectiveness, CDC reviewed prenatal HIV-antibody testing rates associated with these approaches. Medical record data suggest that the "opt-in" voluntary testing approach is associated with lower testing rates than either the "opt-out" voluntary testing approach or the mandatory newborn HIV testing approach.
Highlights
SINCE 1994, THE AVAILABILITY OF INcreasingly effective antiretroviral drugs for both the prevention of perinatal human immunodeficiency virus (HIV)
Project indicated that the majority of women will accept HIV testing if it is rec2680 ommended by their health-care provider
Chart abstraction can document only prenatal HIV testing recorded in maternal medical records; without such documentation, clinicians might not be aware of the need to offer effective perinatal interventions to infected women and their HIVexposed infants
Summary
SINCE 1994, THE AVAILABILITY OF INcreasingly effective antiretroviral drugs for both the prevention of perinatal human immunodeficiency virus (HIV). States and Canadian provinces have implemented three different prenatal HIVtesting approaches To assess their effectiveness, CDC reviewed prenatal HIVantibody testing rates associated with these approaches. Two states (New York and Connecticut) require HIV testing of newborns whose mothers were not tested during pregnancy. Network review of medical records in seven counties in the Rochester area indicated that the proportion of pregnant women who received a prenatal HIV test increased from 52% of 438 charts during January 1998–July 1999 to 83% of 112 charts during August-December. PRAMS data for 1999 indicated that the proportion of women statewide who reported having received an HIV test during pregnancy increased from 69% of 758 women during JanuaryJuly to 93% of 502 during AugustDecember. Statewide analyses of prenatal testing reported on newborn metabolic screening forms from all live-born infants, New York reported prenatal HIV-testing rates of 89%.
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