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This Article Figures Only Full Text Full Text (PDF) All Versions of this Article: AJPH.2007.110023v1 AJPH.2007.110023v2 98/10/1857    most recent Submit a response View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Peters, V. B. Articles by Thomas, P. A. Search for Related Content PubMed PubMed Citation Articles by Peters, V. B. Articles by Thomas, P. A. Related Collections Epidemiology HIV/AIDS Birth Outcomes Pregnancy Other Maternal and Infant Health Surveillance

Vicki B. Peters, MD, Kai-Lih Liu, PhD, MPH, Lisa-Gaye Robinson, MD, Kenneth L. Dominguez, MD, MPH, Elaine J. Abrams, MD, Balwant S. Gill, PhD and Pauline A. Thomas, MD

Vicki B. Peters, Kai-Lih Liu, and Balwant S. Gill are with the New York City Department of Health and Mental Hygiene, New York, NY. Lisa-Gaye Robinson and Elaine J. Abrams are with College of Physicians & Surgeons, Columbia University, Harlem Hospital Center, New York. Kenneth L. Dominguez is with Centers for Disease Control and Prevention, Atlanta, Ga. Pauline A. Thomas is with the Department of Obstetrics, Gynecology & Women's Health, New Jersey Medical School, Newark, NJ.

Correspondence: Send correspondence to Vicki B. Peters, MD, HIV Epidemiology and Field Services Program, New York City Department of Health and Mental Hygiene, 346 Broadway, Room 706, New York, NY 10013 (e-mail: vpeters{at}health.nyc.gov).

Objectives. We examined trends in perinatal HIV prevention interventions in New York City implemented during 1994 to 2003 to ascertain the success of the interventions in reducing perinatal transmission.

Methods. We used data obtained from infant records at 22 hospitals. We used multiple logistic regression to analyze factors associated with prenatal care and perinatal HIV transmission.

Results. We analyzed data for 4729 perinatally HIV-exposed singleton births. Of mothers with prenatal care data, 92% had prenatal care. The overall proportion who received prenatal care and were diagnosed with HIV before delivery was 86% in 1994 to 1996 and 90% in 1997 to 2003. Use of prenatal antiretrovirals among mothers who received prenatal care was 63% in 1994 to 1996 and 82% in 1997 to 2003. From 1994 to 2003, cesarean births among the entire sample increased from 15% to 55%. During 1997 to 2003, the perinatal HIV transmission rate among the entire sample was 7%; 45% of mothers of infected infants had missed opportunities for perinatal HIV prevention. During 1997 to 2003, maternal illicit drug use was significantly associated with lack of prenatal care. Lack of prenatal, intrapartum, and neonatal antiretrovirals; maternal illicit drug use; and low birthweight were significantly associated with perinatal HIV transmission.

Conclusions. Interventions for perinatal HIV prevention can successfully decrease HIV transmission rates. Ongoing perinatal HIV surveillance allows for monitoring the implementation of guidelines to prevent mother-to-child transmission of HIV and determining factors that may contribute to perinatal HIV transmission.