title: The missing link: documentation of recognized maternal human immunodeficiency virus infection in exposed infant birth records, 24 United States jurisdictions, 1999-2003.
abstract: Despite substantial improvements, perinatal human immunodeficiency virus (HIV) transmission has not been eliminated in the United States. We examined the extent and contribution of missed communication opportunities between obstetric and pediatric providers who cared for HIV-infected women and their infants. This was a retrospective review of HIV-exposed infants whose data were reported to the Centers for Disease Control and Prevention Enhanced Perinatal Surveillance System from 1999-2003 (n = 8115). For approximately 4% of the HIV-exposed infants whose data were reported to the Enhanced Perinatal Surveillance System between 1999 and 2003, recognized maternal HIV infection was not documented in the exposed infants' birth records. Such infants were at higher risk of not receiving appropriate neonatal antiretroviral prophylaxis (adjusted odds ratio, 37.3; 95% CI, 24.6-56.4) and had increased odds of HIV infection (adjusted odds ratio, 1.7; 95% CI, 1.1-2.6). Enhanced communication between pediatric and obstetric and gynecologic providers to eliminate this missed opportunity for prevention would improve HIV infection outcomes for HIV-exposed infants and improve care for their mothers.
authors.affiliation: Epidemiology Branch, Division of HIV/AIDS Prevention, National Center for HIV, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA. ataylor2@cdc.gov
authors.forename: Allan W
authors.initials: AW
authors.lastname: Taylor
authors.forename: Nan
authors.initials: N
authors.lastname: Ruffo
authors.forename: Judy
authors.initials: J
authors.lastname: Griffith
authors.forename: Athena P
authors.initials: AP
authors.lastname: Kourtis
authors.forename: Jill
authors.initials: J
authors.lastname: Clark
authors.forename: Michael
authors.initials: M
authors.lastname: Lindsay
authors.forename: Donata
authors.initials: D
authors.lastname: Green
authors.forename: Denise J
authors.initials: DJ
authors.lastname: Jamieson
mesh_terms: D001719:Birth Certificates; D004282:Documentation; D005260:Female; D015658:HIV Infections / Q000635:transmission; D006801:Humans; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control; D033183:Interdisciplinary Communication; D009774:Obstetrics; D010372:Pediatrics; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious; D012189:Retrospective Studies; D018570:Risk Assessment; D014481:United States