Prenatal Care Key to Stopping HIV Spread to Infants

While rates of mother-to-infant HIV spread have dropped dramatically in industrialized countries like the US, when it does occur a lack of prenatal care is largely to blame, findings from a new study suggest.

While rates of mother-to-infant HIV spread have dropped dramatically in industrialized countries like the US, when it does occur a lack of prenatal care is largely to blame, findings from a new study suggest. In an effort to reduce such HIV spread, the US Public Health Service released guidelines in the mid-1990s recommending universal prenatal HIV counseling, voluntary testing, and anti-HIV drug use for pregnant women found to be infected. Several reports have shown that the risk of mother-to-child HIV spread can be reduced if the mother takes AIDS drugs during pregnancy and if the baby receives such drugs for a few days after birth. In the current study, reported in this week’s Morbidity and Mortality Weekly Report, researchers from the Centers for Disease Control and Prevention assessed compliance with these recommendations at Grady Memorial Hospital in Atlanta between 1997 and 2000. Of the 253 infants born to HIV-infected mothers during the study period, 17 were infected, lead author Dr. S. Nesheim and colleagues report. The transmission rates ranged from a low of 3 percent in 1999 to a high of 10 percent in 2000. Throughout the four-year period, the percentage of HIV-infected women who received one or more AIDS drugs held steady at around 75 percent. Moreover, rates of infant AIDS drug use never fell below 92 percent. No cases of HIV spread occurred among women who received complete prenatal care, prenatal HIV testing, and AIDS drugs, the authors note. Of the nine cases that occurred in 1999 and 2000, six involved mothers who received no prenatal care. In the remaining three cases, some prenatal care was provided but the timing or compliance with the AIDS drugs was suboptimal. “For pregnant women who receive prenatal care and know their HIV status, prevention programs should focus on promoting adherence to recommended treatment regimens and administering (AIDS drugs) during pregnancy,” the CDC notes. “Efforts to reduce (mother-to-infant) HIV transmission should continue to focus on increasing prenatal care rates and prenatal HIV testing, particularly in areas where missed opportunities for prevention of perinatal HIV transmission persist,” the group adds. (Source: Morbidity and Mortality Weekly Report, January 2, 2004: Reuters Health News: January 2004)