Research
Perinatal Transmission Higher in Women with Incident HIV
A meta-analysis done by researchers in Washington found that the pooled perinatal transmission rate was 22.7% among pregnant and postpartum women worldwide with incident HIV, which is 2.8-fold higher than women with chronic HIV infection. This is significant for the prevention of perinatal…
"Mississippi Baby" Shows Detectable Levels of HIV
According to the National Institutes of Health (NIH), the child known as the "Mississippi Baby" - an infant seemingly cured of HIV that was reported as a case study of a prolonged remission of HIV infection in The New England Journal of Medicine last fall—now has detectable…
Repeat Third Trimester HIV Testing Uptake
Acceptability and feasibility of third trimester repeat HIV testing was explored following two documented cases of HIV seroconversion during pregnancy. Researchers found that most women were amenable to repeat third trimester HIV testing with the acceptance rate at 97.1%. No women were identified…
Review of HIV Screening in Hospital Labor and Deliveries
In order to estimate prenatal HIV screening rates prior to and on admission to labor and delivery as well as review hospital policies around these practices, researchers conducted a survey of hospitals and maternal/infant medical records in 2006. At that time, only 36% of hospitals had a…
Challenges Towards Elimination of Perinatal HIV in the US
Although perinatal HIV transmission is nearly zero in many groups throughout the United States, there are still those groups that are seeing consistently high rates of transmission. Researchers looked at HIV-exposed infants referred for follow-up care over a seven year period and found…
Revised HIV Surveillance Case Definition
The CDC and The Council of State and Territorial Epidemiologists have revised and combined the surveillance case definitions for HIV infection into a single case definition for persons of all ages and includes the most recent laboratory criteria and multitest algorithms. Further information…
Using Financial Incentives to Motivate Perinatally-Infected Youth to Adhere to Medications
Past research has shown that financial incentives are effective in improving adherence to medication regimines. Researchers tested this technique with adolescents who were perinatally-infected with HIV and have had poor adherence in the past. The pilot project showed that financial…
New HIV Testing Algorithm and Detection of Acute HIV
The MMWR reported in its June 21, 2013 issue about a new testing algorithm evaluated in an ED and other sites to determine effectiveness of HIV detection, especially in cases of acute HIV infection. Whereas traditional testing algorithms may miss cases of acute HIV due to …
Rapid Point-of-Care HIV Tests versus Lab Tests
Researchers looked at the varied performace of rapid point-of-care HIV tests versus traditional laboratory testing in detecting both new/acute and established HIV infections. While some rapid tests were found to perform well, oral fluid rapid tests were found to have less accuracy in…
Cured Infant Remains HIV-Free
The infant born HIV-positive in Mississippi and started on ART at 30 hours of age continues to show no sign of HIV-1 infection at 30 months of age. The infant received ART for 18 months after birth. This case shows the potential for early ART initiation to effect the long-term prognosis of HIV-1 in…
Women with HIV and High Rates of Intimate Partner Violence
Women have a higher risk of HIV infection when affected by intimate partner violence. In addition, high rates of intimate partner violence amongst HIV-positive women have been linked to poorer health outcomes, including less engagement in HIV care. Providers should work with these…
Perinatal HIV Elimination in High Resource Settings
While much of the focus on elimination of mother-to-child transmission of HIV has been in low resource settings, there is still work to be done in high resource settings. As women are living longer with the help of ART, more HIV-positive women are having children. Providers need to ensure proper…
Use of Fourth-Generation Rapid HIV Tests for Diagnosis in Children
Fourth-generation HIV rapid tests have been shown not to be effective in diagnosing HIV in infants with a p24 antigen specificity of <2%. Although sample sizes were small, researchers do not feel they can recommend the use of the 4th generation rapid tests for diagnosis of…
HIV Status Disclosure and Pregnancy
Often disclosure of HIV status is studied as a dichotomous variable - either yes, disclosed or no, did not disclose. In wanting to learning more about the process and barriers to disclosure, researchers underwent a qualitative analysis of the experience of disclosure of women who were…
Risks of Mother-to-Child Transmission from Non-Disclosure of HIV Status
Researchers from the French Perinatal Cohort study found that women who did not disclose their HIV-positive status to their partners during pregnancy had a less than optimal experience with perinatal HIV prevention. Although disclosure status did not result in additional perinatal…
PrEP and Timed Intercourse for HIV Serodiscordant Couples
Researchers found that in 53 cases where the HIV-positive partner was virally supressed, the use of PrEP and timed intercourse was successful in achieving pregnancy at a rate of 75%. This research suggests further studies are needed in resource limited areas to determine other ways to achieve…
Premastication and Perinatal HIV Transmission
As premastication of food for infants has been shown to result in HIV transmission, researchers studied late diagnoses of pediatric HIV to determine if premastication occurred in any of these cases. It was more of a common practice than realized among HIV-positive caregivers. Providers and others…
Special Issue on PrEP in the US - American Journal of Preventive Medicine
The American Journal of Preventive Medicine published a special issue on PrEP in the United States. Articles in the supplement focus on implementation of pre-exposure prophylaxis (PrEP), lessons learned from implementation of post-exposure prophylaxis (PEP), and adherence, among others.…
HIV Screening by OB-GYNs - What Influences It?
Researchers surveyed ACOG Fellows to determine rates of HIV testing among patient populations. Respondents reported almost universal levels of recommendation of HIV testing to pregnant women, however low levels of repeat third trimester recommendations. Practitioners were less influenced by local…
Ruptured Membranes and Perinatal HIV Transmission Risk
A prospective study showed that perinatal HIV transmission rates were slightly higher in women who had ruptured membranes for four hours or more (1.9% versus 1% in women with less than 4 hours of rupture). Of the women in the cohort with viral loads less than 1000 copies/mL at delivery, there were…
Success of Perinatal Rapid HIV Testing in Illinois
Implementation of the Perinatal Rapid Testing Implementation Initiative in Illinois (PRTII) has contributed to significant and sustained decreases in the number of women and infants being discharged after delivery with an unknown HIV status. Between 2005 and 2011, Illinois saw a 63% decrease in…
Adolescent HIV Infection and Increased Perinatal Transmission
A review of HIV-positive infants at an urban referral center documented four cases of perinatal transmission where the mother was an adolescent who tested HIV-negative during pregnancy. These cases provide support for repeat third trimester HIV testing, especially in adolescents.
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A Framework to Eliminate HIV MTCT
In the current issue of Pediatrics, the CDC describes in detail its framework for elimination of perinatal HIV in the United States. The CDC presents a model by which elimination efforts can be coordinated, beginning with comprehensive reproductive health care and real-time case finding of…
Coping of African-American Women Living with HIV
The authors extensively interviewed 30 African American women to determine how they moved forward from their HIV diagnosis and learned to live with the disease. They found that various non-profits assisted in the shift of their belief of HIV as a death sentence. Citation: Watkins-Hayes C,…
Seroconversion During Pregnancy and Perinatal Transmission
Researchers at the CDC found an eight-fold increase in perinatal transmission of HIV in those women that seroconverted during pregnancy compared to those that seroconverted prior to pregnancy. This statistic strengthens the case for early HIV testing during pregnancy and repeat third trimester…