Abstract
In 1994, the US Public Health Service published guidelines for the use of zidovudine to decrease the risk of perinatal transmission of human immunodeficiency virus (HIV). In 1995, the American Academy of Pediatrics and the US Public Health Service recommended documented, routine HIV education and testing with consent for all pregnant women in the United States. Widespread incorporation of these guidelines into clinical practice has resulted in a dramatic decrease in the rate of perinatal HIV transmission and has contributed to more than a 75% decrease in reported cases of pediatric acquired immunodeficiency syndrome (AIDS) since 1992. Substantial advances have been made in the treatment and monitoring of HIV infection; combination antiretroviral regimens that maximally suppress virus replication are now available. These regimens are recommended for pregnant and nonpregnant individuals who require treatment. Risk factors associated with perinatal HIV transmission are now better understood, and recent results from trials to decrease the rate of mother-to-child HIV transmission have contributed new strategies with established efficacy. However, perinatal HIV transmission still occurs; the Centers for Disease Control and Prevention estimates that 300 to 400 infected infants are born annually. Full implementation of recommendations for universal, routine prenatal HIV testing and evaluation of missed prevention opportunities will be critical to further decrease the incidence of pediatric HIV infection in the United States. This technical report summarizes recent advances in the prevention of perinatal transmission of HIV relevant to screening of pregnant women and their infants.
Highlights
In 1994, the US Public Health Service published guidelines for the use of zidovudine to decrease the risk of perinatal transmission of human immunodeficiency virus (HIV)
The American Academy of Pediatrics (AAP) recommended documented HIV education and routine testing with consent for all pregnant women in the United States in 1995; the US Public Health Service recommended universal prenatal HIV counseling and testing in 1995.3,4 Since a significant decrease in new cases of pediatric HIV infection and reported cases of pediatric acquired immunodeficiency syndrome (AIDS) has been observed, raising the possibility that perinatal HIV infection could be eliminated in the United States
Remarkable changes in pediatric HIV infection have been observed in the United States since 1994, when the results of Pediatric AIDS Clinical Trials Group (PACTG) protocol 076 showed that administration of ZDV to the woman during pregnancy and labor and to the newborn decreased the risk of mother-to-child transmission by nearly 70%
Summary
Among women of childbearing age, the rate of HIV infection has continued to increase in the United States. 6 December 2000 1 of 12 in 1999, only 11% of males acquired HIV infection via heterosexual contact, compared with 69% of females.[7] Women with HIV infection acquired via heterosexual contact are often unaware of their partner’s risk of HIV infection.[8,11] In 1999, 32% of young women with AIDS had no risk reported or identified; many of these women were likely infected through heterosexual contact with a partner who was not known to be infected with HIV.[7] AIDS cases in women continue to be concentrated in the northeast and large metropolitan areas, the epidemic affects all regions, the southeast, as well as rural areas.[12,13] During 1999, the annual incidence of AIDS in women in Florida was the third highest in the United States, with only New York and the District of Columbia having higher rates.[7]. Rates among black women were 3 to 35 times higher than those among white women regardless of geographic area of residence
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
