Disparities in rates of HIV infection during pregnancy and trends across the decade, 1998-2007

Purpose: We assessed the prevalence of HIV in pregnancy from 1998-2007, overall and across sub-populations in the State of Florida. Methods: We analyzed all births in the State of Florida from 1998-2007 (N=1,738,860) using hospital discharge data linked to birth certificate records. HIV prevalence rates as well as trend statistics were computed overall and across socio-demographic subpopulations. Results: During the study period, the prevalence of HIV in pregnancy decreased from 311 per 100,000 births to 258 per 100,000 births in a progressive fashion (p for trend <0.0001) representing a 21% decrease from 1998 to 2007. The overall prevalence of HIV in pregnancy was 289 cases per 100,000 births with pronounced differences among the three major racial/ethnic groups in the state. Hispanic mothers had about twice the rate of white mothers (158 vs. 70 per 100,000) and black mothers had about 15 times the rate of white mothers (1012 vs. 70 per 100,000). The rates of HIV in pregnancy were about 5 times as high (561 vs. 113) in single compared to married mothers. Adolescent mothers (<20) had the lowest rate of HIV in pregnancy compared to those aged 20-29 and 30+ (230, 327 and 255 per 100,000 births respectively). Conclusion: While HIV rates in pregnancy have decreased over the past decade; black and Hispanic mothers have disproportionately high rates of HIV compared to white mothers. Our findings represent a clarion call for increased interventions among minority women of childbearing age, especially those that target single women 20-29 years of age.