Estimated number and characteristics associated with perinatal HIV infections, 33 states, United States, 2003-2007
Background: Perinatal HIV (pHIV) transmission can be
reduced by interventions including prenatal care, HIV testing for pregnant
women, antiretroviral prophylaxis, and avoiding breastfeeding. National data regarding
incidence of pHIV infections in the United States and associated missed
prevention opportunities are needed to guide policy and monitor progress toward
elimination of pHIV. This study describes the maternal and infant
characteristics associated with pHIV infections from 2003 to 2007.
Methods: We examined characteristics
of new pHIV diagnoses in infants born between January 2003 and December 2007
which were reported to the Centers for Disease Control and Prevention (CDC) through
June 2009 from the 33 states with confidential name-based HIV reporting since 2001.
counts per birth year were adjusted for reporting delay and maternal risk
factor. Number of births for incidence calculations were taken from National
Center for Health Statistics vital statistics data.
Results: Between 2003 and 2007, an estimated 463 HIV-infected
infants were born in the 33 states with name-based reporting (3.5/100,000 live
births). Annual incidence declined from 4.5
(2003) to 3.1 (2005), remaining near 3.0 in 2006 and 2007. Black/African American infants accounted for 69%
of cases, Hispanic/Latinos 19%, whites 9%, and other/multiple races 3%. Thirty-four percent of mothers of infected
infants began prenatal care before the 3rd trimester, and 27% of
mothers' HIV status was unknown at the time of delivery; 13% of infants were
breastfed. Twenty-nine percent of the
HIV-infected infants' mothers received antiretroviral medications during
Conclusions: Perinatal HIV incidence in the United
States has declined, but transmissions continued through 2007: many cases had missed
opportunities for prevention. This study
provides the most geographically extensive data available describing US pHIV
transmission. Elimination of pHIV transmission will require improvements in
prenatal care, identification of HIV-infected pregnant women, and assurance of
their receipt of appropriate interventions to maximize womens' and infants'
6th IAS Conference on HIV Pathogenesis and Treatment
"A.W.Taylor, et al.
Estimated number and characteristics associated with perinatal HIV infections, 33 states, United States, 2003-2007.
6th IAS Conference on HIV Pathogenesis and Treatment: