Mother-to-child transmission of HIV decreased

Women with HIV who take antiretroviral medication during pregnancy can reduce the risk of transmitting HIV to their babies to less than 1%.¹ The rates of mother-to-child transmission peaked in 1992², and continue to fall to very low levels, despite an increase in the number of women with HIV giving birth.³

In 1987, the FDA approved the antiretroviral drug azathioprine (AZT) as the first drug for the treatment of HIV.⁴ Treatment with AZT slows the progression of HIV infection and helps prevent the transmission of HIV from infected pregnant women to their babies. In a 1994 NIH study, babies born to HIV-infected women were two-thirds less likely to become infected with HIV if their mother took AZT during pregnancy and if they received AZT after birth.⁵ These results prompted the U.S. Public Health Service to recommend that pregnant women be given AZT to reduce the risk of perinatal transmission of HIV. In 2003, the CDC updated its recommendations to make HIV testing a routine part of all medical care and to endorse universal prenatal testing, with rapid tests during labor and after delivery if the mother was not screened prenatally.⁶ The CDC also recommends repeat screening in the third trimester for those at high risk.⁷

Within 10 years of CDC's initial recommendation in 1994, the mother-to-child transmission of HIV had declined by 94% in the United States, thanks to continued improvements in HIV treatment.⁸ In 2007, the CDC launched the One Test. Two Lives. campaign for health professionals to promote HIV testing of all pregnant women.

Another leading contributor to the decline in mother-to-child transmission of HIV is HRSA's Ryan White Services for Women, Infants, Youth, Children, and Families, Title IV (now Part D) program. The program contributed to a drop in mother-to-child transmission of HIV from about 2,000 babies born HIV-positive in 1990 to around 200 in 2005.⁹

Sources

1. CDC, HIV Among Pregnant Women, Infants, and Children
2. CDC, Achievements in Public Health: Reduction in Perinatal Transmission of HIV Infection --- United States, 1985--2005
3. CDC, HIV Among Pregnant Women, Infants, and Children
4. FDA, HIV/AIDS Historical Time Line 1981-1990
5. NIH, NIAID, HIV Infection in Women
6. CDC, Revised Recommendations for HIV Testing of Adults, Adolescents, and Pregnant Women in Health-Care Settings
7. CDC, STDs & Pregnancy – CDC Fact Sheet
8. CDC, Revised Recommendations for HIV Testing of Adults, Adolescents, and Pregnant Women in Health-Care Settings
9. HRSA, Part D: Women and Families in a Circle of Care