title: The effectiveness of state and national policy on the implementation of perinatal HIV prevention interventions.
abstract: OBJECTIVE
  The 1994 and 1995 US Public Health Service Guidelines regarding HIV testing and treatment for pregnant women and the resulting 1995 California law mandating an HIV test and treatment offer to every pregnant woman aim to reduce perinatal HIV transmission. However, the effectiveness of such policies after implementation is often unclear. We analyzed the association between these policies and offers of HIV tests and treatment to HIV-infected women in California.
  
  
  METHODS
  Data from active, population-based surveillance of 496 HIV-infected women and their infants, collected from 1987 to 2002, were analyzed to compare rates of offers of HIV tests and treatment before and after 1996.
  
  
  RESULTS
  We found significant increases in offers of HIV tests (P<.001) and offers of treatment (P<.001) when we compared women who delivered between 1987 and 1995 with those who delivered between 1996 and 2002. Receipt of prenatal care was the major predictor of both test and treatment offer. A significant shift in reported HIV risk factors was also evident between the 2 groups.
  
  
  CONCLUSIONS
  Our findings of increased offers of HIV tests and treatment to HIV-infected pregnant women suggest that the national guidelines and the 1996 California law improved health care for these women, which may lessen the risk of perinatal HIV transmission.
authors.affiliation: Department of Pediatrics, Stanford University School of Medicine, Stanford, Calif, USA. cleas@stanford.edu
authors.forename: Clea C
authors.initials: CC
authors.lastname: Sarnquist
authors.forename: Shayna D
authors.initials: SD
authors.lastname: Cunningham
authors.forename: Barbara
authors.initials: B
authors.lastname: Sullivan
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Maldonado
mesh_terms: D000328:Adult; D002140:California / Q000453:epidemiology; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000517:prevention & control* / Q000635:transmission*; D006291:Health Policy; D006801:Humans; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control* / Q000706:statistics & numerical data; D008403:Mass Screening; D011159:Population Surveillance; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology / Q000517:prevention & control*; D014481:United States / Q000453:epidemiology