142nd APHA Annual Meeting and Exposition

Home Events & Meetings Annual Meeting Schedule & Program

Online Program

Annual Meeting Recordings are now available for purchase

298946
Missed opportunities for perinatal HIV prevention and prenatal care in Louisiana

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Sunday, November 16, 2014

Elliott Brannon, MPH , STD/HIV Program, Office of Public Health, Louisiana Department of Health and Hospitals, New Orleans, LA
Jessica Fridge, MPH , STD/HIV Program, Office of Public Health, Louisiana Department of Health and Hospitals, New Orleans, LA
Jessica Diedling, MPH , Bureau of Family Health, Office of Public Health, Louisiana Department of Health and Hospitals, New Orleans, LA
Background. When HIV is diagnosed in a mother before or during pregnancy and no opportunities for treatment are missed, MCT can be reduced to less than 1%. In 2012, Louisiana’s rate of MCT was over 4%.

Methods. Using data from Louisiana’s Enhanced HIV/AIDS Reporting System (eHARS) an analysis was conducted to determine the effects of PNC on MCT. A logistic regression was used to determine the association between total MOs and MCT for women with PNC and women without PNC. MOs include late diagnosis, no perinatal ARVs, no cesarean section (if indicated), and breastfeeding.

Results. Of the 2,101 HIV-infected women with information on prenatal care, 17% of those with PNC had MOs for prevention and MCT in this group was 2%. For those women without PNC, 83% had MOs for prevention and MCT in this group was 11%. The interaction term between PNC and MOs for MCT was significant such that p <0.0001. MCT was associated with MOs for prevention for women with PNC (OR =3.41, CI 95% = 2.48–4.68), but not for women without PNC (OR=0.87, CI 95%=0.49–1.56).

Conclusions. HIV-infected pregnant women without PNC had a much higher rate of MCT than those with prenatal care, however, MOs for prevention were only associated with MCT in women with PNC. This study highlights the necessity of PNC for all HIV-infected women and supports the reduction of MOs for MCT. This reduction can be accomplished through provider adherence to screening (including third trimester testing) and treatment recommendations for HIV in Louisiana.

Learning Areas:

Epidemiology
Public health or related research

Learning Objectives:
Describe factors that contribute to the high rate of mother-to-child transmission (MCT) of HIV in Louisiana. Explore the relationship between missed opportunities (MOs) for prevention of MCT of HIV and prenatal care (PNC) in Louisiana from 2000 to 2012.

Keyword(s): HIV/AIDS, Maternal and Child Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the Perinatal Surveillance Supervisor for the Louisiana STD/HIV program and have been working as an epidemiologist for the past 4 years. I have presented my work relating to perinatal HIV and congenital syphilis at conferences (most recently the 2013 International Society for Disease Surveillance) and to groups such as the CSTE HIV subcommittee.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 2038.0: Personal, structural, and institutional risk markers and Interventions associated with reproductive and perinatal health