Prevention of perinatal transmission of HIV in Arkansas

In 1994, the Centers for Disease Control and Prevention (CDC) recommended zidovudine (ZDV) prophylaxis to reduce perinatal transmission of HIV. Caregivers at the University of Arkansas for Medical Sciences (UAMS) instituted a program of universal voluntary HIV testing of pregnant females combined with maternal education regarding ZDV prophylaxis in October 1994. Since that time, 7 of 39 (18%) infants referred to Arkansas Children's Hospital (ACH) for evaluation of perinatal HIV exposure have been infected compared to 21 of 53 (40%) referred prior to October 1994, (p = 0.042). Unfortunately, of the 39 infants referred to ACH after October 1994, 21 were born to HIV-infected mothers who did not comply with prophylaxis. Fifteen of these mothers were not offered intravenous ZDV during delivery; five have children infected with HIV. These data indicate the need for increased efforts by health officials in Arkansas to institute nationally recommended methods of prevention of perinatal HIV.