April 04, 2017
4 min read

Incidence of perinatal HIV infections remain 1.75 times higher than CDC goal

You've successfully added to your alerts. You will receive an email when new content is published.

Click Here to Manage Email Alerts

We were unable to process your request. Please try again later. If you continue to have this issue please contact customerservice@slackinc.com.

Although perinatal HIV infections among infants born in the United States have significantly declined since 2002, occurrence remains 1.75 times greater than the goal set in place by the CDC to eliminate mother-to-child transmission, according to a study published in JAMA Pediatrics.

“Although identification of HIV infection is a necessary first step in appropriate treatment and prophylaxis, reports indicate that a quarter of pregnant women have not been tested,” Allan W. Taylor, MD, MPH, from the Division of HIV/AIDS Prevention at the CDC, and colleagues wrote. “In addition, substantial proportions of women with known HIV infection did not receive adequate prenatal care or [antiretroviral] medications.”

Researchers estimated the number of perinatal infants infected with HIV in the U.S. and District of Columbia. To do so, they collected data from 2003 to 2013 in the National HIV Surveillance System, which included receipt of perinatal HIV testing, treatment and prophylaxis. The effect of delays in diagnosis and reporting on the overall estimation was accounted for by a weighted system that took into consideration the length of time between time of birth to diagnosis in each reported case.

Between 2002 and 2013, the number of perinatally infected infants decreased from 216 to 69. The majority of mothers who gave birth to HIV–infected infants identified as black (63.0%, 836 infants), followed by Latino or Hispanic (18.3%, 243 infants). Of the mothers included in the analysis between 2002 and 2005, 37.5% were diagnosed with HIV before pregnancy; however, 51.5% of mothers who were pregnant between 2010 and 2013 had a prior diagnosis.

Regarding maternal HIV treatment in 2002-2005, 22.4% of women and their infants received all prenatal, intrapartum and postnatal antiretroviral prophylaxis or treatment. This proportion increased by 2010-2013, with 31.8% receiving necessary treatment. A similar increase was seen in those who received antiretroviral prophylaxis or treatment during pregnancy (28.4% to 40.3%). A substantial portion of infants born with HIV infection (38.0%) were in five Southern states, specifically Florida, Texas, Georgia, Louisiana and Maryland. National data on perinatal HIV infection in the U.S. suggest that 1.75 per 100,000 live births involved HIV–infected infants.

“The continuing prevalence of missed prevention opportunities suggests that the remaining HIV transmissions occur in a subset of the population that is particularly difficult to reach with the recommended interventions,” Taylor and colleagues wrote. “One could hypothesize that the difficulty in reaching this population may also be reflected by the increasing percentage of women who, although infection was diagnosed before pregnancy, had not apparently been successfully linked to — and retained in — care.”

According to the researchers, “the fact that infants continue to acquire HIV infection appears to be the result of the same reasons that have been known for years and likely not as a result of a previously unrecognized factor, such as increasing [antiretroviral] resistance or an increasing incidence of women with acute HIV infection during pregnancy.” — by Katherine Bortz

Disclosure: The researchers report no relevant financial disclosures.