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Toward Elimination of Perinatal HIV Transmission in the U.S.: Progress of CDC-Funded Prevention Programs, Surveillance, Education & Training

Margaret A. Lampe, RN, MPH1, Stephanie L. Sansom, PhD, MPP, MPH1, Norma S. Harris, PhD2, Nan Ruffo2, and Mary Glenn Fowler, MD, MPH1. (1) Epidemiology Branch, Division of HIV/AIDS Prevention, National Center for HIV, STD and TB Prevention, CDC, 1600 Clifton Road, Mailstop E-45, Atlanta, GA 30333, 404-639-5189, mlampe@cdc.gov, (2) Division of HIV/AIDS Prevention-Surveillance and Epidemiology, U.S. Centers for Disease Control and Prevention, 1600 Clifton Rd NE, MS E-47, Atlanta, GA 30333

ISSUES: Perinatally-acquired AIDS cases in the U.S. have declined dramatically. However, perinatal HIV testing is not universal, and some HIV-infected pregnant women still do not receive effective interventions. CDC estimates 280-370 new perinatal HIV infections annually. DESCRIPTION: Since 1999, Congress has appropriated $10 million annually for perinatal HIV prevention (PHP). CDC distributes the funds via 3 activities: 1) intensive PHP programs in 16 highest prevalence areas; 2) professional education by 5 national organizations; and 3) enhanced perinatal HIV surveillance (EPS) to monitor the epidemic. Five key types of programs have been implemented in the 16 areas: outreach, provider training, social marketing, prevention case management, and rapid HIV testing of women who present in labor with unknown HIV status. CDC and key partners have recently developed a national model rapid HIV testing protocol. Three key outcomes are used to evaluate program impact: 1) prenatal HIV testing rates, 2) receipt of appropriate treatment among HIV-infected pregnant women and their infants and 3) trends in perinatal HIV transmission rates. Methods to measure HIV testing rates vary widely across states. Treatment and transmission outcome data are gathered through HIV/AIDS Reporting System (HARS) and EPS. LESSONS LEARNED: Estimates of testing rates by state ranged from 25% - > 90%. Transmission rates in 13 areas funded for perinatal prevention declined from 6.0% in 1999 to 4.2% in 2001 (p=.002). RECOMMENDATIONS: Comprehensive perinatal prevention activities should coordinate efforts of prevention, key national provider organizations, and surveillance. Future funding should expand strategies that optimize routine universal testing for all pregnant women and standardize methods to monitor HIV testing rates among pregnant women across the U.S.

Learning Objectives:

Keywords: Perinatal Health, HIV/AIDS

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

HIV/AIDS Research Roundtable: Perinatal HIV Testing and Prevention

The 132nd Annual Meeting (November 6-10, 2004) of APHA