Introduction The use of highly active antiretroviral therapy (HAART) during pregnancy and zidovudine during labor and subsequently to the newborn has greatly reduced the number of cases of perinatally transmitted HIV infection in the United States. Although many accomplishments have been achieved in the prevention of mother-to-child transmission of HIV, several challenges remain that result in new perinatal HIV infections. Any perinatal infection is currently seen as a sentinel event and is extensively reviewed to identify any missed opportunity.
Methods Clark County maintains a name-based HIV reporting system. We reviewed the data on women of childbearing age diagnosed and living with HIV/AIDS in Clark County (including Las Vegas), Nevada, from June 2005 through May 2006. Data were collected on the status of their HIV care. Women were classified as out of care if during the review period they were aware of their HIV serostatus and received no treatment or blood monitoring tests. Data were also collected on infants born to these women during this period.
Results Five thousand three hundred six people were living with HIV/AIDS between June 1, 2005, and May 31, 2006. Four hundred ninety-five (9.2%) of these were women of childbearing age (15-44 years), of whom 61% (304/495) were out of care. Among women out of care, approximately 42% (127/304) were Caucasian, 40% (122/304) African American, 14% (43/304) Hispanic, and 4% (12/304) other racial/ethnic groups. Thirty-two (10.5%) were aged 15 to 19 years. During the same period, 20 infants were born, of whom 20% (4/20) have been confirmed with HIV infection. All infected infants (100%) were born to mothers with poor or no prenatal care and three (75%) of the mothers were unaware of their HIV serostatus prior to delivery.
Conclusion Expanded access to care (including prenatal care) and expanded HIV testing for all women of childbearing age remain a major strategy to continuing the achievements made toward eliminating mother-to-child transmission of HIV infection.
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