Number of perinatally acquired AIDS cases, by quarter year of diagnosis, 1984 through 1997. Estimates are based on cases reported through September 1997, adjusted for reporting delay and unreported risk but not for incomplete reporting of diagnosed AIDS cases. Points represent estimated quarterly incidence, and the line represents ''smoothed" incidence. SOURCE: CDC, 1997e.

(65 versus 16 per 10,000 births), and higher than average among Hispanics (19 per 10,000 births). The incidence rate for whites and others is substantially lower than average (3 per 10,000 births), leading to a 32 to 1 differential between African-American and white incidence rates (CDC, 1996b; Ventura et al., 1997).

Figure 3.2 shows trends in the number of perinatal AIDS cases, by race and ethnicity, from 1979 through 1996. The number of African-American children with AIDS grew through 1992 and fell by about 42% between 1992 and 1996. The number of cases in Hispanic children was relatively flat from 1987 through 1992 and fell by 43% between 1992 and 1996. The number of perinatal AIDS cases in white children fell by 50% between 1992 and 1996.

Trends by age at diagnosis (Table 3.2) show that the largest declines are among children diagnosed as infants, with substantial declines also among children diagnosed at ages one to five years. For older children, similar levels of decline have not been observed (CDC, 1997d). These findings are consistent with the expectation that efforts to prevent perinatal transmission would be reflected earliest in infants because older children were born before antiretroviral therapy was used widely in pregnancy (Appendix D).

Pneumocystis carinii pneumonia (PCP) is the most common AIDS-defining condition in children. Since recommendations regarding PCP prophylaxis were

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