sources were highlighted: the Survey of Childbearing Women (SCBW); the STEP project; a provider survey; and an assessment of pregnant women's knowledge, attitudes, and beliefs regarding the use of ZDV (convenience sample, 170 pregnant women).

Incorporation and Implementation of Guidelines

Since 1995, New Jersey has had a law requiring mandatory counseling and voluntary testing of all pregnant women. The law stipulates three components: HIV counseling, offering testing, and testing. A physician-to-physician peer education program has been implemented in the state. The New Jersey Department of Health and Senior Services (NJDHSS) funded and collaborated with the Academy of Medicine and the State Medical Society on a statewide symposium on the prevention of perinatal HIV transmission in 1997. The NJDHSS also funds and collaborates with the Academy of Medicine of New Jersey on roving symposia of the topic. Finally, a public education campaign has been undertaken, including the use of posters, postcards, videos, and public service announcements. These discuss the benefits of ZDV in preventing perinatal HIV transmission.

Trends/Findings

Prevention of perinatal HIV transmission is a public health priority in New Jersey, since it is the state with the highest proportion of women among its cumulative AIDS case reports (27%), and it has the third highest number of pediatric AIDS case reports in the nation (695 as of May 31, 1998). Virtually all of New Jersey's pediatric AIDS cases (94%) and HIV-infected pediatric cases (98%) are the result of perinatal transmission.

In New Jersey, HIV seroprevalence among pregnant women peaked in 1991 at 0.56% and declined through 1997, when it was 0.27%. Cumulative seroprevalence rates among childbearing women in New Jersey since 1991 are 1.47% for African Americans, 0.48% for Hispanic women, and 0.10% for whites. While the rate is declining among all racial and ethnic groups, the state's African-American women are disproportionately affected, with rates 14.7 times that of their white counterparts and 3 times greater than that of Hispanic women.

Results from New Jersey's Survey of Childbearing Women (SCBW) indicate that the percentage of HIV-infected pregnant women receiving ZDV increased significantly between 1994 and 1995, from 13% to 48%. An analysis of factors associated with ZDV use indicates that women less than 30 years old were more likely than those 30 and older to have used ZDV in pregnancy. It is estimated that ZDV use in New Jersey prevented perinatal HIV transmission to 28 children in 1995.

STEP provides information on the use of ZDV during the three perinatal



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