Reducing the Odds

Thousands of HIV-positive women give birth every year. Further, because many pregnant women are not tested for HIV and therefore do not receive treatment, the number of children born with HIV is still unacceptably high. What can we do to eliminate this tragic and costly inheritance? In response to a congressional request, this book evaluates the extent to which state efforts have been effective in reducing the perinatal transmission of HIV. The committee recommends that testing HIV be a routine part of prenatal care, and that health care providers notify women that HIV testing is part of the usual array of prenatal tests and that they have an opportunity to refuse the HIV test. This approach could help both reduce the number of pediatric AIDS cases and improve treatment for mothers with AIDS.


Reducing the Odds will be of special interest to federal, state, and local health policymakers, prenatal care providers, maternal and child health specialists, public health practitioners, and advocates for HIV/AIDS patients. January

Table of Contents


Front Matter
Executive Summary
1 Introduction
2 Public Health Screening Programs
3 Descriptive Epidemiology of the Perinatal Transmission of HIV
4 Natural History, Detection, and Treatment of HIV Infection in Pregnant Women and Newborns
5 Context of Services for Women and Children Affected by HIV/AIDS
6 Implementation and Impact of the Public Health Service Counseling and Testing Guidelines
7 Recommendations
References
Appendixes
A Committee and Staff Biographies
B Context of Services for Women and Children Affected by HIV/AIDS
C Workshop I Summary
D Workshop II Summary
E New York/New Jersey Site Visit Summary
F Alabama Site Visit Summary
G South Texas Site Visit Summary
H Florida Conference Summary
I HIV Testing and Perinatal Transmission: Thoughts from an HIV-Positive Mother
J Human Immunodeficiency Virus Antibody Testing Among Women 15-44: Results from the 1995 National Survey of Family Growth
K Details of the Committee's Models and Assumptions
L Passing the Test: New York's Newborn HIV Testing Policy, 1987-1997
M Excerpts from the Ryan White CARE Act Amendments of 1996
N 1995 U.S. Public Health Service Recommendations for Human Immunodeficiency Virus Counseling and Testing for Pregnant Women
O Acronyms and Glossary
Index