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Implications for Human Immunodeficiency Virus Testing Programs of Pregnant Women

Sheldon Landesman, MD; Howard Minkoff, MD; Susan Holman, RN, MS; Sandra McCalla, MD; Odalis Sijin, MD

JAMA. 1987;258(19):2701-2703.

Abstract
Although perinatal transmission of the human immunodeficiency virus (HIV) is well documented, seroprevalence rates of HIV in populations of women of reproductive age have not yet been reported. To determine the seroprevalence of HIV in childbearing women from a population with a high incidence of acquired immunodeficiency syndrome, cord blood samples were collected from 602 infants delivered at an inner-city municipal hospital in New York. Demographic and HIV risk factor information was also collected from mothers of these infants. Twelve (2%) of 602 samples (95% confidence interval, 1% to 4%) were positive for HIV on enzyme-linked immunosorbent assay and Western blot analysis. In interviews, seven of 12 seropositive women had risk factors as defined by the Centers for Disease Control, Atlanta; the remaining five seropositive women had no self-identified risk factors. The HIV seroprevalence rate in our hospital (2.0%) is several times higher than that of many other diseases for which screening is already routine. This serosurvey indicates that HIV infection of inner-city parturients is a significant problem that warrants broadly implemented health strategies. Furthermore, the data also suggest that if risk factor information elicited by physicians is used to initiate HIV antibody counseling and testing of pregnant women, a significant number of seropositive parturients is missed. In areas with significant seroprevalence rates of HIV infection, a broader counseling and testing program may be needed.

(JAMA 1987;258:2701-2703)

Author Affiliations
From the Departments of Medicine (Dr Landesman and Ms Holman) and Obstetrics and Gynecology (Drs Minkoff and McCalla), State University of New York Health Science Center at Brooklyn; and the Department of Obstetrics and Gynecology, New York University (Dr Sijin).

Footnotes
Reprint requests to Box 56, SUNY-Health Science Center at Brooklyn, 450 Clarkson Ave, Brooklyn, NY 11203 (Dr Landesman).

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