Achievements in Public Health: Reduction in Perinatal Transmission of HIV Infection --- United States, 1985-2005

L Mofenson, MD; AW Taylor, MD; M Rogers, MD; M Campsmith, DDS; NM Ruffo; J Clark, MPH; MA Lampe, MPH; AK Nakashima, MD; S Sansom, PhD


Morbidity and Mortality Weekly Report. 2006;55(21):597-603. 

In This Article


During 2005, an estimated 92% of acquired immunodeficiency syndrome (AIDS) cases reported among children aged <13 years in the United States were attributed to mother-to-child transmission of human immunodeficiency virus (HIV) (CDC, unpublished data, 2006). Transmission can occur during pregnancy, labor, delivery, or breastfeeding. Estimates of the number of perinatal HIV infections peaked in 1991 at 1,650[1] and declined to an estimated range of 144–236 in 2002 (CDC, unpublished data, 2006). This reduction is attributed to routine HIV screening of pregnant women, use of antiretroviral (ARV) drugs for treatment and prophylaxis, avoidance of breastfeeding, and use of elective cesarean delivery when appropriate. With these interventions, rates of HIV transmission during pregnancy, labor, or delivery from mothers infected with HIV have been reduced to less than 2%,[2] compared with transmission rates of 25%–30% with no interventions.[3]

Despite these gains, substantial challenges to reducing perinatal transmission of HIV remain. Every perinatal HIV infection represents a sentinel health event, often indicating a woman who had undiagnosed HIV infection before pregnancy or did not receive appropriate interventions to prevent transmission of the virus to her infant. Therefore, to strengthen and sustain measures to maximally reduce perinatal transmission, public health activities should give high priority to collection of data to identify where missed opportunities occur and target prevention efforts accordingly.


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