Mother-to-child transmission of the human immunodeficiency virus in Texas

Background. The Pediatric Spectrum of HIV Diseases (PSD) project has been c ollecting data on HIV-exposed children in Texas since 1989. These data have now been analyzed to describe mother-to child transmission in Texas and to provide much needed information on the magnitude of the pediatric HIV epid emic in the state. Methods. We examined trends in the numbers of perinatally exposed children and perinatally acquired cases of HIV in the Texas PSD cohort. We calculate d transmission rates and relative risks for 656 children born from January, 1995, to July, 1998, that received all or part of the ACTG 076 regimen. Results. Only a small proportion (38%) of pairs of an HIV-infected mother a nd her HIV-exposed child received the full AIDS Clinical Trial Group 076 (A CTG 076) regimen; only 73% of the mothers received at least some prenatal c are. In recent years, however, the numbers of perinatally exposed children and perinatally acquired cases of HIV have decreased in Texas. Univariate a nalyses showed that a reduction in the vertical trans mission of HIV was as sociated with receipt of a full ACTG 076 regimen, receipt of a partial ACTG 076 regimen and residence in Dallas County. Conclusions. Findings identify a gap in meeting the health care needs of pr egnant HIV-infected women and suggest missed opportunities to prevent mothe r-to-child transmission of HIV. At the same time this study confirms progre ss in prevention efforts to reduce mother to child transmission of HIV in T exas.