Prenatal care utilization and the implementation of prophylaxis to prevent perinatal HIV-1 transmission.
OBJECTIVE
To describe prenatal care utilization among women with HIV-1 in 4 US states, and to determine whether the adequacy of prenatal care utilization is associated with the implementation of prenatal, intrapartum, and postnatal HIV antiretroviral therapy (ARV).


METHODS
Three-hundred three women completed a prenatal interview. Prenatal, labor and delivery, and infant medical records were reviewed.


RESULTS
Thirty-nine percent of women did not receive adequate prenatal care; nearly one quarter of women did not begin care within the recommended timeframe, and approximately one-fifth of women received fewer than the recommended number of prenatal care visits from the time of entry into care until delivery. Those classified as less than adequate in terms of receipt of recommended visits were at increased risk for not receiving ARV during the prenatal care period and during labor and delivery, and were more likely to have had an infant subsequently diagnosed with HIV infection.


CONCLUSIONS
Although women with HIV require adequate prenatal care for their own health as well as to improve perinatal outcomes, many are at risk for not receiving this care. Lower adherence to prenatal care appointments is an important risk factor for not receiving full HIV prophylactic regimens.
Wilson
Tracey E
TE
State University of New York Downstate Medical Center, Brooklyn, New York 11203, USA. tracey.wilson@downstate.edu
Ickovics
Jeannette R
JR
Royce
Rachel
R
Fernandez
M Isabel
MI
Lampe
Margaret
M
Koenig
Linda J
LJ
D000328:Adult; D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D018890:Chemoprevention; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000208:ethnology / Q000517:prevention & control; D006801:Humans; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control* / Q000706:statistics & numerical data; D007407:Interviews as Topic; D016015:Logistic Models; D008137:Longitudinal Studies; D008499:Medical Records; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy* / Q000208:ethnology; D011295:Prenatal Care / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology
D044966:Anti-Retroviral Agents