Vicki B. Peters ^1*, Kai-Lih Liu ¹, Lisa-Gaye Robinson ², Kenneth L. Dominguez ³, Elaine J. Abrams ², Balwant S. Gill ¹, Pauline A. Thomas ⁴

¹ New York City Department of Health and Mental Hygiene, New York, NY
² Columbia University, College of Physicians & Surgeons, Harlem Hospital Center, New York, NY
³ Centers for Disease Control and Prevention, Atlanta, GA
⁴ Department of Obstetrics, Gynecology & Women's Health, New Jersey Medical School, Newark, NJ

^* To whom correspondence should be addressed. E-mail: vpeters{at}health.nyc.gov.

	Abstract

Objectives. We examined trends in perinatal HIV prevention interventions in New York City implemented during 1994 to 2003.

Methods. We used data from infant records at 22 hospitals. We used multiple logistic regression to analyze factors associated with prenatal care and perinatal HIV transmission.

Results. We analyzed data for 4729 perinatally HIV-exposed singleton births. Of mothers with prenatal care data, 92% had prenatal care. The overall proportion who received prenatal care and were diagnosed with HIV before delivery was 75% in 1994 to 1996 and 83% in 1997 to 2003. Use of prenatal antiretrovirals among mothers who received prenatal care was 63% in 1994 to 1996 and 82% in 1997 to 2003. From 1994 to 2003, cesarean births among the entire sample increased from 15% to 55%. During 1997 to 2003, the perinatal HIV transmission rate among the entire sample was 7%; 45% of mothers of infected infants had missed opportunities for perinatal HIV prevention. During 1997 to 2003, maternal illicit drug use was significantly associated with lack of prenatal care. Lack of prenatal, intrapartum, and neonatal antiretrovirals; maternal illicit drug use; and low birthweight were significantly associated with perinatal HIV transmission.

Conclusions. Interventions for perinatal HIV prevention can successfully decrease HIV transmission rates.

Key Words: Epidemiology, HIV/AIDS, Maternal and Infant Health, Surveillance