Reducing the Odds Preventing Perinatal Transmission of HIV in the United States (1999) / Chapter Skim
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N 1995 U.S. Public Health Service Recommendations for Human Immunodeficiency Virus Counseling and Testing for Pregnant Women
N 1995 U.S. Public Health Service Recommendations for Human Immunodeficiency Virus Counseling and Testing for Pregnant Women
Pages 347-371
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APPENDIX N 1995 U.S. Public Heubb Service Recommendudons far Human ImmunodeAciency Drug CounseUng and Awing for Pregnant amen Ha/
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Public Health Service Recommendations for Human Immunodeficiency Virus Counseling and Voluntary Testing for Pregnant Women U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES ~sERv,c' Public Health Service of*
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U.S. Public Health Service recommendations for human immunodeficiency virus counseling and voluntary testing for pregnant women.
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44 / No. RR-7 351 MMWR Contents Introduction 1 Background 2 HIV Infection and AIDS in Women and Children 2 Perinatal Transmission of HIV 3 HIV Prevention and Treatment Opportunities for Women and Infants 3 Counseling and Testing Strategies 5 Laboratory Testing Considerations 6 Recommendations 8 HIV Counseling and Voluntary Testing of Pregnant Women and Their Infants 8 Interpretation of HIV Test Results 9 Recommendations for HlV-lnfected Pregnant Women 10 Recommendations for Follow-Up of Infected Women and Perinatally Exposed Children Rnf~r~nn.~ i Single copies of this document are available from the Centers for Disease Control and Prevention, National AIDS Clearinghouse, PO.
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The following persons either served as consultants at the workshop for developing the recommendations for HIV counseling and voluntary testing for pregnant women or were members of the U.S. Public Health Service Task Force on the Use of Zidovudine to Reduce Perinatal Transmission of Human Immunodeficiency Virus.
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Baylor College of Medicine Houston, TX Cheryl Healton, Dr.P.H. Columbia School of Public Health New York, NY Lisa Hernandez For AIDS Children Everywhere Cincinnati, OH Richard Hoffman, M.D., M.P.H.
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University of Puerto Rico School of Medicine San Juan, PR July 7, 1995 U.S. Public Health Service Task Force on the Use of Zidovudine to Reduce Perinatal Transmission of Human Immunodeficiency Virus Lynne M
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APPENDIX N Vol.
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RR-7 MMWR U.S. Public Health Service RecommencIations for Human ImmunocIeficiency Virus Counseling and Voluntary Testing for Pregnant Women Summer,/ These recommendations were developed by the lJ,S, Pc/b/ic //e~/th Service to address the increasing epidemic of human /mmunodeficienc,v virus {///I/J infection among women and their infants, The recommendations stress the importance of erg/ diagnosis of ///Vinfection for the health of both women and the/rinf~nts and are based on advances made in ///I/-re/~ted treatment~nd,orevention, The most significant advance for this po,c~u/~tion has been the results from ~ p/acebo-contro//ed, clinic/ trio/ that indicated that administration of zidovadine to ///V-infectedpregnant women and their newborns reduced the risk for print/ transmission of ///V by ~,o,oroximate/y two thirds {1 J
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encourage HlV-infected pregnant women to learn their infection status; b) advise infected pregnant women of methods for preventing perinatal, sexual, and other modes of HIV transmission; c)
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358 REDUCING THE ODDS Vol.
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Foremost among these strategies has been administration of ZDV to HlV-infected pregnant women and their newborns ( 1)
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) regarding HIV counseling and testing of pregnant women recommended a targeted approach directed to women known to be at increased risk for HIV infection (e.g., injecting-drug users and women whose sex partners were HlV-infected or at risk for infection)
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where prevalence data are inadequate, outdated, or unavailable, and would miss substantial numbers of HlV-infected pregnant women in areas with lower seroprevalence rates but high numbers of births (e.g., California)
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. No large-scale studies to estimate the prevalence of indeterminate test results in pregnant women have been conducted.
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. Uninfected pregnant women who continue to practice high-risk behaviors (e.g., injecting-drug use and unprotected sexual contact with an HlV-infected or high-risk partner)
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Uncertainties regarding HIV infection status, including laboratory test results, should be resolved before final decisions are made concerning pregnancy termination, ZDV therapy, or other interventions. · Pregnant women who have repeatedly reactive EIA and indeterminate supplemental tests should be retested immediately for HIV antibody to distinguish between recent seroconversion and a negative test result.
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. HlV-infected pregnant women should be evaluated to determine their need for psychological and social services.
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Confidential HlV-related information should be disclosed or shared only in accordance with prevailing legal requirements. Counseling for HlV-infected pregnant women should include an assessment of the potential for negative effects resulting from HIV infection (e.g., discrimination, domestic violence, and psychological difficulties)
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Hassig SE, et al. Perinatal transmission of the human immunodeficiency virus type I to infants of seropositive women in Zaire.
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Public Health Service Task Force on the-Use of Zidovudine to Reduce Perinatal Transmission of Human Immunodeficiency Virus.
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Performance characteristics of serologic tests for human immunodeficiency virus type 1 (HIV-1) antibody among Minnesota blood donors: public health and clinical implications.
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CDC. Recommendations for prophylaxis against Pneumocvsf/s c~rinlipneumonia for adults and adolescents infected with human immunodeficiency virus.
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APPENDIX N 37 MMWR The Mo~bidi~vo~7~^eek/~vRepo~t/MMl~RJseries is prepared by the Centers for Disease Control and Prevention (CDC) and is available free of charge in electronic format and on a paid subscription basis for paper copy.
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