Trends in perinatal HIV prevention in New York City, 1994-2003.
OBJECTIVE
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.
Peters
Vicki B
VB
HIV Epidemiology and Field Services Program, New York City Department of Health and Mental Hygiene, 346 Broadway, Room 706, New York, NY 10013, USA. vpeters@health.nyc.gov
Liu
Kai-Lih
KL
Robinson
Lisa-Gaye
LG
Dominguez
Kenneth L
KL
Abrams
Elaine J
EJ
Gill
Balwant S
BS
Thomas
Pauline A
PA
D015492:AIDS Serodiagnosis; D019380:Anti-HIV Agents / Q000627:therapeutic use; D002585:Cesarean Section / Q000639:trends; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control* / Q000635:transmission; D019538:Health Care Surveys; D006801:Humans; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control* / Q000706:statistics & numerical data; D016015:Logistic Models; D015999:Multivariate Analysis; D009519:New York City; D010500:Perinatology / Q000639:trends*; D011159:Population Surveillance; D011181:Postnatal Care / Q000639:trends*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control*; D011295:Prenatal Care / Q000639:trends*; D015980:Public Health Practice; D012307:Risk Factors; D019966:Substance-Related Disorders / Q000150:complications; D017211:Treatment Failure; D019037:Urban Health Services / Q000639:trends
D019380:Anti-HIV Agents