Research
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…
Non-Disclosure of HIV Status to Partner and Prevention of Perinatal HIV
The French Perinatal Cohort study found that while non-disclosure of HIV status to the male partner was associated with late initiation of ART, detectable viral load at delivery and lack of infant treatment, overall rates of perinatal transmission were not different between women who did not…
Artificial Reproduction Techniques for Conception in Serodiscordant Couples
Serodiscordant couples in which the infected partner is the male have been successful in utilizing sperm washing in combination with other techniques such as intrauterine insemination (IUI) to reduce the risk of HIV transmission to the female partner during conception. A detailed literature review…
ART Use Can Prevent HIV Transmission to Uninfected Partner
NIAID study HPTN 052 released early results due to overwhelming success in prevention of HIV transmission among serodiscordant couples. Those HIV-infected individuals that started ART immediately were overwhelmingly more likely to not transmit HIV to the uninfected partner than those individuals…
Why Women Decline Rapid HIV Test at Delivery
Women with an undocumented HIV status at time of labor who declined a rapid HIV test via informed consent were more likely to have had prenatal care than those who consented. This declination may result from a prior offer of HIV testing during routine prenatal care or discussions via informed…
PrEP to Prevent HIV During Conception
Pre-exposure prophylaxis (PrEP) should be considered as an option for serodiscordant couples wishing to conceive since most other options (sperm washing and artifical insemination for example) are not viable options for most couples. Especially in countries where HIV is endemic, the use of PrEP to…
Recent HIV Infection Associated with In-Utero HIV Transmission
Using mathematical modeling, women in Malawi who were determined to be recently infected with HIV were almost three times as likely to see in-utero HIV transmission than those who had been infected for longer periods of time. Transmission rates were 17.8% for recently infected women and 6.7% for…
Case Studies Supporting Third Trimester HIV Screening
This article presents three case studies in which women had negative HIV tests during regular first trimester screening but were later diagnosed as HIV-positive after delivery. Two of the three infants were also HIV-positive. As all three women were not considered to be high-risk for HIV…
Cost-Effectiveness of Directly Observed Therapy for Perinatal HIV Prevention
Researchers used mathematical modeling to analyze the effect of women on self-administered HAART versus HAART using directly observed therapy (DOT) versus no HAART on quality of life of their infants. DOT was overall highly cost-effective in reducing mother-to-child transmission. Especially…
New Estimates of Number of Infants Born to HIV-Infected Women
New data on the number of HIV-exposed infants born in the U.S. estimates 9,000 infants were born in 2006. This is an increase of up to 30% as compared to the estimate of infants born in 2000. The authors suggest this increase is likely reflective of an overall increase in the number of women…