Research
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…
Estimated Number of HIV-Exposed Infants Born in US
This study aimed to estimate the number of infants born to HIV-infected women in the U.S. and its dependencies in 2006. The estimated number of births in 2006 to all women living with HIV (diagnosed or undiagnosed) was 8,700. This number is approximately 30% greater than the number of such births…
Promising Results for Preventing HIV MTCT in Resource-Limited Settings
Two recent studies published in the New England Journal of Medicine and summarized here in Obstetrical and Gynecological Survey, describe promising approaches to reducing HIV MTCT in the developing world. The first study conducted at antenatal clinics in Malawi examined the efficacy of a…
A Comprehensive Approach to Preventing MTCT of HIV
The Journal of Public Health Management Practice features a recent issue with articles from the New York State Department of Health describing the programs and policies that have led to a significant reduction in perinatal transmission of HIV in that state. See below to access a selection of…
Missed Opportunities in Perinatal HIV Prevention
The Enhanced Perinatal Surveillance (EPS) data collected in 10 states and 5 cities from 2005-2008 showed a number of missed opportunities for prevention of transmission of HIV from mom to baby. Overall, 60% of women did not receive all the recommended interventions to prevent transmission. These…
Risk Factors for Detectable HIV-1 RNA at Delivery
In the United States, more than 6000 women with HIV become pregnant each year. Numerous interventions have been put into place which can decrease the risk of newborn HIV infection to less than one percent for many patients. The Women and Infants Transmission Study (WITS) previously published data…
Opt-Out HIV Testing in EDs - Effective?
Diagnostic HIV testing was compared to nontargeted opt-out rapid HIV testing in an emergency department. Approximately 75% of ED patients declined HIV testing when offered. Of those identified to have a new HIV diagnosis, slightly more were identified through opt-out testing. A majority of…
Factors Associated with Declining a Rapid HIV Test
A secondary analysis of data from the Mother-Infant Rapid Intervention at Delivery (MIRIAD) study found that decliners of rapid HIV testing in labor and delivery were more likely to have received prenatal care. Testing in labor and delivery was seen as redundant, although in some cases women may…
Factors Associated with Prenatal Care Among Women in MIRIAD Study
Prenatal care allows not only for the opportunity to provide obstetrical care to women during pregnancy, but also to screen women at risk for other health conditions or complications of pregnancy, and identify medical and psychological risk factors. This study sought to evaluate factors associated…
Evidence to Support Repeat Third Trimester HIV Testing for Pregnant Women
The authors report on 3 cases of perinatal HIV infection in central Ohio. The mothers all had negative first trimester HIV test results and were not re-screened in the third trimester of pregnancy. All had risk factors for HIV infection of which they were unaware. The authors suggest considering…
Factors Related to In-Utero HIV Mother to Child Transmission
In developing nations, most interventions to prevent HIV-1 MTCT target the transmission that occurs either at the time of delivery or during the infant breast-feeding period. In-utero transmission (transmission that occurs before the baby has been born) accounts for 20-30% of HIV-1 infected infants…
Factors Associated with MTCT of HIV Despite Optimal Conditions
The rate of MTCT of HIV-1 among mothers who delivered in the French Perinatal Cohort between 1997 and 2006 was 1.5%. Even when optimal conditions were met-- meaning a term delivery of 37 weeks or more to a mother receiving antiretroviral therapy (ART), with the last maternal viral load at or prior…
Use of the Rapid HIV Test for Third Trimester Screening
A study conducted in an ambulatory obstetrics and gynecology clinic in Philadelphia, PA revealed that 95% of women agreed to be rescreened with a rapid HIV test in the third trimester of pregnancy. Of the participants, 91% reported the rapid HIV test was less stressful than conventional testing…
Premasticated Food for Infants Potential HIV Risk
This study reviews three cases in the United States where perinatal transmission of HIV has been ruled out, but infants have been diagnosed with "late" HIV transmission. In each, case a parent or caregiver routinely fed premasticated food to the child and epidemiologically, it has been…
Benefits of Early Initiation of Antiretroviral Therapy
Study finds improved survival in patients receiving early antiretroviral therapy as compared to those in the deferred therapy group. Citation: Kitahata MM, Gange SJ, Abraham AG, et al. Effect of early versus deferred antiretroviral therapy for HIV on survival. N Engl J Med. 2009 Apr 1.…
Early Antiretroviral Therapy Reduces Infant Mortality
Early diagnosis of HIV and early antiretroviral therapy reduced infant mortality and HIV progression in the Children with HIV Early Antiretroviral Therapy (CHER) trial. Citation: Violari A, Paed FC, Cotton MF, Gibb DM, Babiker AG, Steyn J, Madhi SA, Paed FC, Jean-Philippe P, McIntyre JA, CHER…
Mothers on the Margins
This study utilized a high-risk group of HIV-infected mothers as expert informants on childbearing with HIV to inform strategies to eradicate perinatal HIV transmission. Citation: Lindau ST, Jerome J, Miller K, Monk E, Garcia P, Cohen M. Mothers on the margins: implications for eradicating…