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Maternal-newborn human immunodeficiency virus infection in Harlem
S W Nicholas1, D A Bateman, S K Ng
1Department of Pediatrics, Harlem Hospital Center, College of Physicians and Surgeons of Columbia University, New York, NY.
Archives of Pediatrics & Adolescent Medicine
|August 1, 1994
Summary
Most mothers infected with human immunodeficiency virus type 1 (HIV-1) acquired it through heterosexual contact, not injected drug use. Routine HIV-1 testing during pregnancy is recommended due to the high rate of undiagnosed infections.
Area of Science:
- Infectious Diseases
- Public Health
- Epidemiology
Background:
- Human immunodeficiency virus type 1 (HIV-1) infection poses a significant public health challenge.
- Understanding transmission routes and prevalence in pregnant populations is crucial for intervention.
Purpose of the Study:
- To determine the prevalence of HIV-1 infection among mothers delivering infants at an inner-city hospital.
- To investigate the association between HIV-1 infection and illicit drug use in this population.
Main Methods:
- Anonymous HIV-1 antibody testing of umbilical cord blood from singleton infants born between 1989.
- Linking test results to a de-identified maternal-infant database.
- Statistical analysis to identify factors associated with HIV-1 seropositivity.
Main Results:
- HIV-1 seroprevalence was 3.3% (99/2971) among mothers.
- Maternal HIV-1 infection was associated with cocaine use, history of injected drug use, syphilis, and increasing maternal age.
- Voluntary testing failed to identify 71% of infected mothers.
Conclusions:
- Heterosexual transmission appears to be the primary route of HIV-1 acquisition for infected mothers in this cohort.
- Cocaine use, syphilis, and older maternal age are associated with increased HIV-1 risk, likely due to behavioral or biological factors.
- The high rate of undiagnosed infections supports routine HIV-1 testing during pregnancy and in the newborn period.