title: Ongoing Maternal-Child Transmission of HIV in an Urban Area, 2003-2012.
abstract: OBJECTIVE
  Mother-to-child transmission of HIV can be prevented by prenatal and peripartum interventions. We sought to determine the prevalence of vertical HIV transmission in an urban cohort of HIV-exposed infants and describe cases of vertical HIV infection presenting during and after the neonatal period.
  
  
  METHODS
  This retrospective cohort study included HIV-exposed infants born between July 1, 2003, and June 30, 2012, who received care at an urban referral site.
  
  
  RESULTS
  There were 516 infants with HIV exposure known by the time of delivery; 9 of these infants (1.7%; 95% confidence interval: 0.8%-3.3%) were HIV infected. The HIV infection rate was 0.7% for those receiving prenatal antiretroviral (ARV) therapy and 9.3% for those receiving only intrapartum and/or postnatal ARV therapy. Among those diagnosed with HIV at delivery, 46% received no prenatal care.
  
  
  CONCLUSIONS
  Our data suggest that strategies to eliminate infant HIV infections ought to include ensuring better access to prenatal care, HIV testing, and ARV therapy initiation during pregnancy.
authors: Divisions of General Pediatrics and Special Immunology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; and.
authors: Richard M
authors: RM
authors: Rutstein
authors: Divisions of General Pediatrics and Special Immunology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; and.
authors: Kathleen M
authors: KM
authors: Volkman
authors: Divisions of General Pediatrics and Special Immunology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; and.
authors: Sirisha
authors: S
authors: Bonda
authors: Divisions of Hospital Medicine and Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio samir.shah@cchmc.org.
authors: Samir S
authors: SS
authors: Shah
mesh_terms: D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D015331:Cohort Studies; D016001:Confidence Intervals; D036861:Delivery, Obstetric / Q000379:methods / Q000706:statistics & numerical data; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000517:prevention & control / Q000635:transmission; D006301:Health Services Needs and Demand; D006801:Humans; D007223:Infant; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D008297:Male; D011181:Postnatal Care / Q000379:methods; D011247:Pregnancy; D011295:Prenatal Care / Q000379:methods; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology
chemical_list: D044966:Anti-Retroviral Agents
keywords: human immunodeficiency virus; prevention