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Epidemiology of Perinatal HIV Transmission in the United States in the Era of Its Elimination

Nesheim, Steven R., MD*,†; FitzHarris, Lauren F., MPH*,†,‡; Mahle Gray, Kristen, MPH*,§; Lampe, Margaret A., RN, MPH*,†

The Pediatric Infectious Disease Journal: June 2019 - Volume 38 - Issue 6 - p 611–616
doi: 10.1097/INF.0000000000002290
HIV Reports
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The number of infants born with HIV in the United States has decreased for years, approaching the Centers for Disease Control and Prevention’s incidence goal for eliminating perinatal HIV transmission. We reviewed recent literature on perinatal HIV transmission in the United States. Among perinatally HIV-exposed infants (whose mothers have HIV, without regard to infantsHIV diagnosis), prenatal and natal antiretroviral use has increased, maternal HIV infection is more frequently diagnosed before pregnancy and breast-feeding is uncommon. In contrast, mothers of infants with HIV are tested at a lower rate for HIV, receive prenatal care less often, receive antiretrovirals (prenatal and natal) less often and breastfeed more often. The incidence of perinatal HIV remains 5 times as high among black than white infants. The annual number of births to women with HIV was estimated last for 2006 (8700) but has likely decreased. The numbers of women of childbearing age living with HIV and HIV diagnoses have decreased. The estimated time from HIV infection to diagnosis remains long among women and men who acquired HIV heterosexually. It is important to review the epidemiology and to continue monitoring outcomes and other health indicators for reproductive age adults living with HIV and their infants.

From the *Division of HIV/AIDS Prevention

Epidemiology Branch

ICF

§HIV Incidence and Case-Surveillance Branch, Centers for Disease Control and Prevention, National Center for HIV, Viral Hepatitis, Sexually Transmitted disease, and Tuberculosis Prevention, Atlanta, Georgia.

Accepted for publication January 11, 2019.

The authors have no funding or conflicts of interest to disclose.

Disclaimer: The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

Address for correspondence: Steven R. Nesheim, MD, Centers for Disease Control and Prevention, 1600 Clifton Road MS E-45, Atlanta, GA 30329. E-mail: sxn9@cdc.gov.

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