Prevention of vertical HIV transmission with zidovudine: Projected impact of HIV testing and prenatal care

Barbara J. Turner, L. McKee-Nelsen, T. R. Fanning, W. W. Hauck

Research output: Contribution to journalArticlepeer-review

4 Scopus citations

Abstract

We sought to estimate the impact of maternal HIV testing and prenatal care on the potential to reduce vertical transmission through zidovudine (AZT) use by HIV-infected mothers. We evaluated the prepartum maternal HIV diagnosis rate, prenatal care, disease stage, and vertical transmission rate (from a two-part mixture model) using New York State Medicaid and vital statistics data for HIV-infected mothers and their singletons in 1985-90. We used published data to estimate the effect of AZT on vertical transmission and expert input to define other parameters for the model. Our HIV-infected (N = 1514) had a vertical transmission rate of 27.0%. HIV was diagnosed prepartum for 39.5% of women in 1990. Transmission would have been 22.2% if AZT had been taken only by the 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 and maternal HIV diagnosis rates in this Medicaid population-based cohort must be addressed to realize the promise of AZT to reduce vertical transmission.

Original languageEnglish (US)
Pages (from-to)577-588
Number of pages12
JournalAIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV
Volume9
Issue number5
DOIs
StatePublished - 1997

ASJC Scopus subject areas

  • Social Psychology
  • Health(social science)
  • Public Health, Environmental and Occupational Health

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