Estimated Perinatal HIV Infection Among Infants Born in the United States, 2002–2013

Abstract

(Abstracted from JAMA Pediatr 2017;171(5):435–442) Robust interventions to prevent perinatal human immunodeficiency virus (HIV) transmission are well understood and have been available for a number of years. Reduction of maternal HIV viral load using antiretroviral (ARV) therapeutics has become accepted practice in pregnant women similarly to how it is used in nonpregnant women.

Missed opportunities for prevention of vertical HIV transmission in Canada, 1997–2016: a surveillance study

“…Baseline maternal characteristics and delivery-related factors are shown in Table 1. For 60 mother-infant pairs (1.6%) (27 in 1997-2010, 33 in 2011-2016), infant HIV status was indeterminate, with explanation documented in 18 cases (death [10 cases], moved out of Canada [8]); the remaining 42 pairs were lost to follow-up. All deaths occurred within 5 months of birth, and none were attributed to HIV infection.…”

“…of antiretroviral treatment during pregnancy, labour and delivery, preterm delivery and incomplete avoidance of breast-feeding. [7][8][9][10][11] The objectives of the present study were to determine the adequacy, and changes over time in adequacy, of uptake of antenatal and intrapartum maternal and postpartum neonatal antiretroviral therapy for the prevention of vertical HIV transmission, and to determine the vertical transmission rate over time and according to adequacy of antenatal antiretroviral therapy during the combination antiretroviral therapy era (1997)(1998)(1999)(2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008)(2009)(2010)(2011)(2012)(2013)(2014)(2015)(2016) in Canada. We further sought to evaluate recent trends by investigating predictors of inadequate uptake of antenatal antiretroviral therapy for the period 2011-2016.…”

Behavioral Health and Adult Milestones in Young Adults With Perinatal HIV Infection or Exposure

“…1 After decades of scientific discovery, coupled with effective program implementation, there were an estimated 69 new cases of perinatally acquired HIV infection (PHIV) in 2013. 2,3 New York City (NYC) reported only 6 new perinatal infections from 2012 to 2015, a decrease from >300 annually in the early 1990s. 4 In parallel, treatment advances have resulted in decreased mortality and morbidity and an aging population of adolescents and young adults living with perinatally acquired HIV infection (PHIVYAs).…”

Perceptions of Patient HIV Risk by Primary Care Providers in High-HIV Prevalence Areas in the Southern United States

“…Although perinatal HIV infections in the United States decreased by 32% from 2011 to 2015, 65% of perinatal HIV diagnoses in the United States in 2016 were among black/African Americans; social challenges with access to prevention and care services have been described as barriers for women during and after pregnancy. 7,10 In addition, perinatal HIV exposure surveillance and reporting has been difficult due mostly to budget cuts; strengthening resources in this area requires strengthening accurate PHES and reporting processes, especially in areas most affected by perinatal HIV transmission. 10,11 The high number of responses related to mother-to-child transmission may also be due to the fact that 44.9% of K-BAP PCPs who responded specialized in either pediatrics, OB/GYN, or family practice (44.9%).…”

“…7,10 In addition, perinatal HIV exposure surveillance and reporting has been difficult due mostly to budget cuts; strengthening resources in this area requires strengthening accurate PHES and reporting processes, especially in areas most affected by perinatal HIV transmission. 10,11 The high number of responses related to mother-to-child transmission may also be due to the fact that 44.9% of K-BAP PCPs who responded specialized in either pediatrics, OB/GYN, or family practice (44.9%).…”