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Perinatal HIV Prevention Outcomes in U.S.-Born Versus Foreign-Born Blacks, PSD Cohort, 1995-2004
Ranell L Myles1, Melissa Artstein-McNassar, Hazel D Dean
1Centers for Disease Control and Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, 1600 Clifton Road NE, Mailstop E-07, Atlanta, GA, 30333, USA, RMyles@cdc.gov.
Insights
Differences in HIV prevention opportunities exist between U.S.-born and foreign-born Black mothers. Understanding these disparities is crucial for preventing perinatal HIV transmission effectively.
Area of Science:
- Public Health
- Epidemiology
- Infectious Diseases
Background:
- Perinatal HIV transmission remains a significant global health concern.
- Understanding disparities in HIV prevention among different maternal subgroups is essential for targeted interventions.
- Previous research has highlighted variations in healthcare access and outcomes among Black mothers based on their country of origin.
Purpose of the Study:
- To compare perinatal HIV prevention opportunities between U.S.-born and foreign-born Black mothers.
- To investigate differences in HIV exposure and infection rates in infants born to these mothers.
- To explore variations in prevention strategies based on specific geographical origins within foreign-born Black mothers (African-born vs. Caribbean-born).
Main Methods:
- Analysis of data from the Pediatric Spectrum of HIV Disease Project, a longitudinal cohort study (1995-2004).
- Calculation of prevalence ratios to compare HIV prevention opportunities.
- Stratification of foreign-born Black mothers into African-born and Caribbean-born subgroups.
Main Results:
- U.S.-born HIV-infected Black mothers were more likely to report illicit drug use, sex work, and awareness of HIV status before delivery.
- U.S.-born mothers were also more likely to receive intrapartum antiretroviral (ARV) prophylaxis and deliver premature infants.
- Foreign-born mothers, particularly African-born, were more likely to receive intrapartum ARV prophylaxis, while U.S.-born mothers were less likely to deliver HIV-infected infants.
Conclusions:
- Significant differences in perinatal HIV prevention opportunities exist between U.S.-born and foreign-born Black mothers.
- Geographical origin (U.S.-born, African-born, Caribbean-born) influences access to and utilization of HIV prevention strategies.
- Disaggregating data by racial/ethnic subgroups is vital for effective perinatal HIV transmission prevention strategies.
Abstract:
We examined differences in HIV-infected U.S.-born and foreign-born black mothers who delivered perinatally HIV-exposed and -infected children during 1995-2004 in the Pediatric Spectrum of HIV Disease Project, a longitudinal cohort study. Prevalence ratios were calculated to explain differences in perinatal HIV prevention opportunities comparing U.S.-born to foreign-born and African-born to Caribbean-born black mothers. U.S.-born compared with foreign-born HIV-infected black mothers were significantly more likely to have used cocaine or other non-intravenous illicit drugs, exchanged money or drugs for sex, known their HIV status before giving birth, received intrapartum antiretroviral (ARV) prophylaxis, and delivered a premature infant; and were significantly less likely to have received prenatal care or delivered an HIV-infected infant. African-born compared with Caribbean-born black mothers were more likely to receive intrapartum ARV prophylaxis. These differences by maternal geographical origin have important implications for perinatal HIV transmission prevention, and highlight the validity of disaggregating data by racial/ethnic subgroups.