About this item:

425 Views | 447 Downloads

Author Notes:

Email Address: Rana Chakroborty :rchakr5@emory.edu

A.F.C.-G. conceptualized and designed the study, coordinated and supervised data collection and analysis, drafted the initial manuscript, revised and approved the final manuscript submitted.

M.-H.K. collected data, carried out initial analysis and reviewed and revised the manuscript.

A.B., A.R.E., A.C., and R.C. conceptualized and designed the study and reviewed and revised the manuscript.

The authors would like to thank Bridget A. Wynn for assistance with the article.

There are no conflicts of interest.

Subjects:

Research Funding:

A.F.C.-G. has received research funding from Bristol-Myers Squibb. R.C. has received research funding from Gilead Sciences.

A.R.E. has received research funding from Bristol-Myers Squibb, Cubist Pharmaceuticals, and GlaxoSmithKline, and has served as an advisor for Gilead Sciences.

Keywords:

  • Georgia
  • United States
  • HIV
  • mother-to-child transmission
  • pediatrics
  • perinatal HIV

Missed opportunities for prevention of mother-to-child transmission in the United States

Tools:

Journal Title:

AIDS

Volume:

Volume 29, Number 12

Publisher:

, Pages 1511-1515

Type of Work:

Article | Final Publisher PDF

Abstract:

Objective: To describe system failures potentially contributing to perinatal HIV transmission in the state of Georgia, United States, between 2005 and 2012. Design: A retrospective chart review of antenatal and postnatal records of HIV-infected infants between 1 January 2005 and 31 December 2012. Methods: Study participants included all HIV-infected infants referred for specialized management to the Ponce Family and Youth Clinic within Grady Health Systems in Atlanta. Main outcomes included identification of maternal, perinatal, and neonatal risk factors associated with vertical transmission. Results: Twenty-seven cases were identified; 89% of mothers were African–American between 16 and 30 years of age. Seventy-four percent of women knew their HIV status prior to pregnancy, 44% had no prenatal care, and 52% did not receive combination antiretroviral therapy during pregnancy or intrapartum zidovudine. HIV-1 RNA near the time of delivery was available in only 10 of 27 mothers, and of those, only three had an undetectable HIV-1 RNA level. Caesarean section was performed in 70% of women. Of the 27 children, the mean gestational age was 37 (SD: 2.9) weeks, with 33% requiring neonatal ICU admission. Fifty-nine percent were men, and only 67% received postnatal zidovudine prophylaxis. Conclusion: Mother-to-child transmission of HIV continues to occur in Georgia at unacceptable levels. Increased education with adherence to existing national guidelines, as well as coordinated efforts between healthcare and public health providers to improve linkage and retention in medical care are urgently needed to prevent further vertical transmission events in Georgia.

Copyright information:

© 2015 Wolters Kluwer Health, Inc.

This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License ( http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits making multiple copies, distribution, public display, and publicly performance, provided the original work is properly cited. This license requires copyright and license notices be kept intact, credit be given to copyright holder and/or author. This license prohibits exercising rights for commercial purposes.

Creative Commons License

Export to EndNote