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This Article Full Text Full Text (PDF) All Versions of this Article: AJPH.2005.072371v1 97/6/1041    most recent Submit a response Purchase Article View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Sarnquist, C. C. Articles by Maldonado, Y. Search for Related Content PubMed PubMed Citation Articles by Sarnquist, C. C. Articles by Maldonado, Y. Related Collections Health Policy HIV/AIDS Birth Outcomes Pregnancy Other Maternal and Infant Health Prevention Surveillance

Clea C. Sarnquist, DrPH, Shayna D. Cunningham, PhD, MHS, Barbara Sullivan, RN, CCRC and Yvonne Maldonado, MD

Clea C. Sarnquist, Barbara Sullivan, and Yvonne Maldonado are with the Department of Pediatrics, Stanford University School of Medicine, Stanford, Calif. Shayna D. Cunningham is with the Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Md.

Correspondence: Requests for reprints should be sent to Clea C. Sarnquist, Cypress Hall, 550 Via Ortega, Stanford, CA 94305 (e-mail: cleas{at}stanford.edu).

Objectives. The 1994 and 1995 US Public Health Service Guidelines regarding HIV testing and treatment for pregnant women and the resulting 1995 California law mandating an HIV test and treatment offer to every pregnant woman aim to reduce perinatal HIV transmission. However, the effectiveness of such policies after implementation is often unclear. We analyzed the association between these policies and offers of HIV tests and treatment to HIV-infected women in California.

Methods. Data from active, population-based surveillance of 496 HIV-infected women and their infants, collected from 1987 to 2002, were analyzed to compare rates of offers of HIV tests and treatment before and after 1996.

Results. We found significant increases in offers of HIV tests (P<.001) and offers of treatment (P<.001) when we compared women who delivered between 1987 and 1995 with those who delivered between 1996 and 2002. Receipt of prenatal care was the major predictor of both test and treatment offer. A significant shift in reported HIV risk factors was also evident between the 2 groups.

Conclusions. Our findings of increased offers of HIV tests and treatment to HIV-infected pregnant women suggest that the national guidelines and the 1996 California law improved health care for these women, which may lessen the risk of perinatal HIV transmission.