Bj. Turner et al., PREVENTION OF VERTICAL HIV TRANSMISSION WITH ZIDOVUDINE - PROJECTED IMPACT OF HIV TESTING AND PRENATAL-CARE, AIDS care, 9(5), 1997, pp. 577-588
Citations number
35
Categorie Soggetti
Social Sciences, Biomedical","Public, Environmental & Occupation Heath",Psychology
We sought to estimate the impact of maternal HIV testing and prenatal
care on the potential to reduce vertical transmission through zidovudi
ne (AZT) use by HIV-infected mothers. We evaluated the prepartum mater
nal HIV diagnosis rate, prenatal care, disease stage, and vertical tra
nsmission rate (from a two-part mixture model) using New York State Me
dicaid and vital statistics data for HIV-infected mothers and their si
ngletons in 1985-90. We used published data to estimate the effect of
AZT on vertical transmission and expert input to define other paramete
rs for the model. Our HIV-infected (N=1514) had a vertical transmissio
n rate of 27.0%. HIV was diagnosed prepartum for 39.5% of women in 199
0. Transmission would have been 22.2% if AZT had been taken only by th
e subset of women diagnosed prepartum with HIV and receiving prenatal
care by 34 weeks gestation (86.7%). Transmission would have dropped to
11.2% if all women had been diagnosed prepartum with HIV and received
adequate prenatal care. The observed deficiencies in prenatal care an
d maternal HIV diagnosis rates in this Medicaid population-based cohor
t must be addressed to realize the promise of AZT to reduce vertical t
ransmission.