title: Missed opportunities to prevent perinatal human immunodeficiency virus transmission in 15 jurisdictions in the United States during 2005-2008.
abstract: The objective of this study was to identify factors related to failure to receive recommended interventions for the prevention of mother-to-child HIV transmission among HIV-infected pregnant women in the United States. Using Enhanced Perinatal Surveillance data from 2005 through 2008, we identified characteristics of HIV-infected women (n = 5,391) that increased their odds of missing an opportunity to prevent perinatal HIV transmission. Adjusted odds ratios (aORs) and 95% confidence intervals (95% CIs) were calculated by using backward step-wise logistic regression analyses to determine the relationship between demographic variables and missed opportunities. Of 4,220 HIV-infected pregnant women with complete data, 2,545 (60%) did not receive all of the recommended interventions. Missed opportunities for prevention occurred more often among HIV-infected women aged 25-34 years (aOR = 1.9, 95% CI = 1.4-2.5), and greater than 34 years (aOR = 2.0, 95% CI = 1.5-2.7) compared to those 13-19 years and among injection drug users (aOR = 1.3, CI = 1.0-1.5) compared to women infected with HIV through heterosexual contact. Clinicians can decrease missed opportunities by routinely providing recommended interventions, especially among HIV-infected women who are injection drug users or aged 25 years or older.
authors.affiliation: Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA. SWhitmore@cdc.gov
authors.forename: Suzanne K
authors.initials: SK
authors.lastname: Whitmore
authors.forename: Alpa
authors.initials: A
authors.lastname: Patel-Larson
authors.forename: Lorena
authors.initials: L
authors.lastname: Espinoza
authors.forename: Nan M
authors.initials: NM
authors.lastname: Ruffo
authors.forename: Shubha
authors.initials: S
authors.lastname: Rao
mesh_terms: D000293:Adolescent; D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D003695:Delivery of Health Care / Q000592:standards*; D005260:Female; D006678:HIV; D015658:HIV Infections / Q000188:drug therapy / Q000517:prevention & control / Q000635:transmission*; D006801:Humans; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D016015:Logistic Models; D016017:Odds Ratio; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy* / Q000821:virology; D012307:Risk Factors; D014481:United States; D055815:Young Adult
chemical_list: D019380:Anti-HIV Agents