infants, and children in the WIC program. However, the committee cautions that state WIC agency program plans should clearly define chronic or recurrent with each condition in its listing of nutrition risk criteria. The committee recommends discontinuation of chronic upper respiratory infections, bronchitis, otitis media, and chronic urinary tract infection (see earlier section) as nutrition risk criteria in the WIC program because of lack of scientific evidence to support nutrition benefit.

HIV Infection and AIDS

Prevalence of and Factors Associated with HIV Infection and AIDS

The growing prevalence of human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome (AIDS) among women (CDC, 1995b) has been accompanied by an increase in the number of children who have been infected perinatally. Mother-to-infant transmission cumulatively accounts for about 90 percent of all pediatric cases (CDC, 1994a). The CDC estimates that 1.6 to 1.7 of every 1,000 women tested in 1992 were HIV seropositive (CDC, 1994b). The prevalence of seropositive infants is much lower.

Women made up 18 percent of adults and adolescents with AIDS reported in 1994. In 1994, CDC estimated that black women made up more than half of all reported cases of HIV/AIDS among women older than 13 years of age, and Hispanic women were also heavily overrepresented. The racial/ethnic distribution was similar for infants and children (CDC, 1994b). No data on the prevalence of HIV/AIDS in the WIC program population were available to the committee.

The strikingly higher rates of HIV/AIDS in blacks and Hispanics are closely linked to poverty; and the ethnic distribution of Americans living in poverty closely resembles the distribution of AIDS cases (National Commission on AIDS, 1992). Populations living in poverty tend to have unequal access to preventive and medical care, lower standards of living, higher levels of unemployment, and higher rates of drug use and alcoholism. A study in Seattle, Washington, found that after controlling for other demographic and behavioral risk, income level was independently associated with HIV infection (Krueger et al., 1990).

Risk indicators for HIV/AIDS include unprotected maternal or paternal sexual activity, maternal or paternal injection of illegal drugs, sexual abuse, bisexuality, exposure to HIV-contaminated blood or blood products, and consumption of HIV-contaminated breast milk (infants only).

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