 |
|
Trends in Perinatal Transmission of HIV/AIDS in the United States
Mary Lou Lindegren, MD;
Robert H. Byers, Jr, PhD;
Pauline Thomas, MD;
Susan F. Davis, MD;
Blake Caldwell, MD, MPH;
Martha Rogers, MD;
Marta Gwinn, MD, MPH;
John W. Ward, MD;
Patricia L. Fleming, PhD
JAMA. 1999;282:531-538.
Context Since 1994, the US Public Health Service (PHS) has recommended routine, voluntary prenatal human immunodeficiency virus (HIV) testing and zidovudine therapy to reduce perinatal HIV transmission.
Objective To describe trends in incidence of perinatal AIDS and factors contributing to these trends, particularly the effect of PHS perinatal HIV recommendations.
Design, Setting, and Participants Analysis of nationwide AIDS surveillance data and data from HIV-reporting states through June 1998.
Main Outcome Measures Trends in AIDS by year of diagnosis, incidence rates of AIDS and Pneumocystis carinii pneumonia (PCP) among infants younger than 1 year from US natality data for birth cohorts 1988 to 1996; expected number of infants with AIDS from national serosurvey data; and zidovudine use data from selected HIV-reporting states.
Results Perinatal AIDS cases peaked in 1992 and then declined 67% from 1992 through 1997, including an 80% decline in infants and a 66% decline in children aged 1 to 5 years. Rates of AIDS among infants (per 100,000 births) declined 69%, from 8.9 in 1992 to 2.8 in 1996 compared with a 17% decline in births to HIV-infected women from 1992 (n=6990) to 1995 (n=5797). Among infants, PCP rates per 100,000 declined 67% (from 4.5 in 1992 to 1.5 in 1996), similar to the decline in other AIDS conditions. The percentage of perinatally exposed children born from 1993 through 1997 whose mothers were tested for HIV before giving birth increased from 70% to 94%; the percentage who received zidovudine increased from 7% to 91%.
Conclusions According to these data, substantial declines in AIDS incidence were temporally associated with an increase in zidovudine use to reduce perinatal HIV transmission, demonstrating substantial success in implementing PHS guidelines. Reductions in the numbers of births and effects of therapy in delaying AIDS do not explain the decline.
Author Affiliations: Division of HIV/AIDS Prevention: Surveillance and Epidemiology, National Center for HIV, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Ga (Drs Lindegren, Byers, Davis, Caldwell, Rogers, Gwinn, Ward, and Fleming); and New York City Department of Health, New York (Dr Thomas). Dr Caldwell is currently with the Office of Health Care Partnership, Epidemiology Program Office; Dr Gwinn with the Office of Genetics and Disease Prevention; and Dr Ward with the Epidemiology Program, Office of Scientific and Health Communication, Centers for Disease Control and Prevention. Dr Davis is currently with the Virginia Department of Health, Richmond.
RELATED ARTICLES
Can Perinatal HIV Infection Be Eliminated in the United States?
Lynne M. Mofenson
JAMA. 1999;282(6):577-579.
EXTRACT
| FULL TEXT
August 11, 1999
JAMA. 1999;282(6):603-604.
EXTRACT
| FULL TEXT
Don't pass on HIV to your child
JAMA. 1999;282(6):606.
PDF
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
Trends in Perinatal HIV Prevention in New York City, 1994-2003
Peters et al.
Am. J. Public Health 2008;98:1857-1864.
ABSTRACT
| FULL TEXT
Diagnosis of HIV-1 Infection in Children Younger Than 18 Months in the United States
Read and and the Committee on Pediatric AIDS
Pediatrics 2007;120:e1547-e1562.
ABSTRACT
| FULL TEXT
Declines in Low Birth Weight and Preterm Birth Among Infants Who Were Born to HIV-Infected Women During an Era of Increased Use of Maternal Antiretroviral Drugs: Pediatric Spectrum of HIV Disease, 1989-2004
Schulte et al.
Pediatrics 2007;119:e900-e906.
ABSTRACT
| FULL TEXT
Specific Problems in Perinatal Infections: A Literature Review
Correia
Indoor and Built Environment 2006;15:25-28.
ABSTRACT
Prenatal Screening for HIV: A Review of the Evidence for the U.S. Preventive Services Task Force
Chou et al.
ANN INTERN MED 2005;143:38-54.
ABSTRACT
| FULL TEXT
Perinatal Exposure to Antiretroviral Agents: Risks and Benefits
Scott
Am. J. Neuroradiol. 2005;26:689-692.
FULL TEXT
Advances in the Prevention of Perinatal HIV-1 Transmission
Shetty and Maldonado
NeoReviews 2005;6:e12-e25.
FULL TEXT
Rapid HIV-1 Testing During Labor: A Multicenter Study
Bulterys et al.
JAMA 2004;292:219-223.
ABSTRACT
| FULL TEXT
Human Milk, Breastfeeding, and Transmission of Human Immunodeficiency Virus Type 1 in the United States
Read and Committee on Pediatric AIDS
Pediatrics 2003;112:1196-1205.
ABSTRACT
| FULL TEXT
Disparity Between Pediatricians' Knowledge and Practices Regarding Perinatal Human Immunodeficiency Virus Counseling and Testing
Kline and O'Connor
Pediatrics 2003;112:e367-367.
ABSTRACT
| FULL TEXT
Missed Opportunities for Perinatal HIV Prevention Among HIV-Exposed Infants Born 1996-2000, Pediatric Spectrum of HIV Disease Cohort
Peters et al.
Pediatrics 2003;111:1186-1191.
ABSTRACT
| FULL TEXT
Determinants of Mother-to-Infant Human Immunodeficiency Virus 1 Transmission Before and After the Introduction of Zidovudine Prophylaxis
The Italian Register for Human Immunodeficiency Vi
Arch Pediatr Adolesc Med 2002;156:915-921.
ABSTRACT
| FULL TEXT
Maternal Adherence to the Zidovudine Regimen for HIV-Exposed Infants to Prevent HIV Infection: A Preliminary Study
Demas et al.
Pediatrics 2002;110:e35-35.
ABSTRACT
| FULL TEXT
Progression of disease in HIV infected children slowed after the first year of life
King
Evid. Based Med. 2002;7:27-27.
FULL TEXT
Is first trimester exposure to the combination of antiretroviral therapy and folate antagonists a risk factor for congenital abnormalities?
Jungmann et al.
Sex. Transm. Infect. 2001;77:441-443.
ABSTRACT
| FULL TEXT
Preventing Mother-to-Child Transmission of HIV-1: An International Perspective
Shetty and Maldonado
NeoReviews 2001;2:e75-82.
FULL TEXT
HIV transmission Prevention of Perinatal HIV-1 Transmission in the United States
Shetty and Maldonado
NeoReviews 2001;2:e83-93.
FULL TEXT
Changing Epidemiology of Perinatal HIV-1 Infection in the United States
Shetty and Maldonado
NeoReviews 2001;2:e94-99.
FULL TEXT
Technical Report: Perinatal Human Immunodeficiency Virus Testing and Prevention of Transmission
Mofenson and the Committee on Pediatric AIDS
Pediatrics 2000;106:88e-88.
ABSTRACT
| FULL TEXT
Perinatal Exposure to Zidovudine -- Benefits and Risks
Mofenson
NEJM 2000;343:803-805.
FULL TEXT
Ethical Considerations in the Treatment of Infertility in Women with Human Immunodeficiency Virus Infection
Minkoff and Santoro
NEJM 2000;342:1748-1750.
FULL TEXT
Prevention of Mother-to-Child HIV Transmission in Resource-Poor Countries: Translating Research Into Policy and Practice
De Cock et al.
JAMA 2000;283:1175-1182.
ABSTRACT
| FULL TEXT
Reducing vertical transmission of HIV in the UK
Nicoll and Peckham
BMJ 1999;319:1211-1212.
FULL TEXT
Can Perinatal HIV Infection Be Eliminated in the United States?
Mofenson
JAMA 1999;282:577-579.
FULL TEXT
|
