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Perinatal HIV Transmission Rates among HIV Infected Pregnant Women in New York State (NYS) N. WADE*, G. BIRKHEAD, M. GOURLAY-DOYLE, R. GLAROS, M. ZIELINSKI, B. WARREN, and B. AGINS.
New York State Dept. of Hlth., AIDS Inst., Albany Since 5/96, NYS has required HIV counseling with recommended testing in regulated facilities; universal newborn testing began in 2/97. We evaluated transmission rates through 12/98.
Methods: Perinatal antiretroviral use, infant infection status, and maternal testing history is obtained through review of prenatal, intrapartum, newborn and pediatric medical records of all HIV exposed newborns identified by newborn screening.
Results: From 2/97 to 12/98, 1,962 HIV positive women gave birth in NYS. To date, infant infection status is confirmed for 1,168 (60%) of seropositive births. Overall transmission rate was 9.2% (107/1, 168). Transmission rate in 1997 was 10.6% (70/662) and in 1998, 7.3% (37/506). In this cohort, 148 (13%) mothers did not receive prenatal care, and 348 (30%) did not receive perinatal antiretroviral prophylaxis. Older women were more likely to transmit HIV to their newborns [age40+: (21%), age 30-39: (10%) , age 20-29: (8%) and age <20(4%)]. HIV transmission was lowest among hispanic women (8.4%), and black women (8.8%) followed by white women (11.4%).
Conclusion: Among this cohort of HIV positive pregnant women delivering in NYS, younger women were more likely to be tested for HIV, have prenatal care, receive perinatal antiretroviral prophylaxis and not transmit HIV to their newborns. Efforts continue to improve access to prenatal care, HIV counseling and testing, and antiretroviral prophylaxis to decrease perinatal HIV transmission among all groups within NYS.
Key Words: Antiretrovirals, Perinatal, Transmission
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