children. To meet this goal, the United States should adopt a national policy of universal HIV testing, with patient notification, as a routine component of prenatal care. Adopting this policy will require the establishment of, and resources for, a comprehensive infrastructure that includes education of prenatal care providers; the development and implementation of practice guidelines; the implementation of clinical policies, the development and adoption of performance measures and Medicaid managed care contract language for prenatal HIV testing; efforts to improve coordination of care and access to high-quality HIV treatment; interventions to overcome pregnant women's concerns about HIV testing and treatment; and efforts to increase utilization of prenatal care, as described above