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Christine A. Hughes, PharmD, Dalyce Zuk, PharmD, Michelle Foisy, PharmD, Joan Robinson, MD, FRCPC, Ameeta E. Singh, BMBS, MSc, FRCPC and Stan Houston, MD, FRCPC

Christine A. Hughes is with the Faculty of Pharmacy and Pharmaceutical Sciences, University of Alberta, Edmonton. At the time of the study, Dalyce Zuk was with Regional Pharmacy Services, Capital Health, Edmonton. Michelle Foisy is with the Northern Alberta HIV Program, Edmonton. Joan Robinson is with the Department of Pediatrics, Division of Infectious Diseases, University of Alberta, Edmonton. Ameeta E. Singh and Stan Houston are with the Department of Medicine, Division of Infectious Diseases, University of Alberta, Edmonton.

Correspondence: Requests for reprints should be sent to Christine A. Hughes, BscPharm, PharmD, Faculty of Pharmacy & Pharmaceutical Sciences, 3126 Dentistry/Pharmacy Centre, University of Alberta Edmonton, AB Canada T6G 2N8 (e-mail: chughes{at}pharmacy.ualberta.ca).

Objectives. We evaluated the effectiveness of a program that includes routine opt-out prenatal HIV screening, combination antiretroviral therapy (ART), and a multidisciplinary team in preventing perinatal HIV transmission.

Methods. A retrospective analysis was performed on HIV-infected pregnant women in northern Alberta, Canada, who delivered between January 1, 1999, and February 28, 2006.

Results. Ninety-eight women had 113 deliveries. Forty-three percent were diagnosed with HIV infection through prenatal screening. Approximately 60% of HIV-infected pregnant women were Aboriginal, with 45% reporting alcohol use and 42% illicit drug use during pregnancy. The use of combination ART during pregnancy increased throughout the study period; 89% or more received combination ART from 2004 through 2006. Only 1 of the 111 infants (0.9%) was confirmed to be HIV infected, and that infant was born to a woman with no prenatal care.

Conclusions. High rates of HIV testing using an opt-out approach, combined with efforts by a multidisciplinary team, resulted in a low rate of perinatal HIV transmission in our cohort. The added value of retesting high-risk women late in pregnancy or with rapid HIV tests at the time of delivery should be explored.