RT Book, Section
A1 Chambliss, Linda R.
A1 Myers, Robert A.
A2 Foley, Michael R.
A2 Strong, Jr, Thomas H.
A2 Garite, Thomas J.
SR Print(0)
ID 1171874042
T1 Human Immunodeficiency Virus in Pregnancy
T2 Obstetric Intensive Care Manual, 5e
YR 1
FD 1
PB McGraw-Hill Education
PP New York, NY
SN 9781259861758
LK obgyn.mhmedical.com/content.aspx?aid=1171874042
RD 2024/04/23
AB Much  has  changed  in  the  care  of  patients  who  are  human  immunodeficiency  virus  (HIV)  positive  since  the  ­epidemic  was  first  recognized  in  the  early  1980s.  Women  comprise  over  half  the  of  the  almost  37  million  people  worldwide  who  are  living  with  HIV  infection  and  about  25%  of  those  in  the  United  States.  It  is  estimated  that  about  one  in  five  patients  infected  with  HIV  are  unaware  of  their  status.  Since  the  2006  recommendation  that  everyone  be  tested  for  HIV  infection  and  simultaneous  intensified  efforts  to  have  all  HIV-infected  people  treated  with  antiretroviral  drugs  (antiretroviral  therapy  [ART]),  the  annual  number  of  HIV  diagnoses  in  the  United  States  fell  by  19%  between  2005  and  2014  according  to  a  Centers  for  Disease  Control  and  Prevention  (CDC)  analysis.  The  number  of  HIV  diagnoses  in  women  declined  40%  during  this  time.  In  2014,  African-American  women  accounted  for  60%  of  the  new  HIV  diagnoses  in  women.  Despite  these  favorable  trends,  there  still  are  about  40,000  HIV  infections  diagnosed  each  year  with  about  8500  HIV  positive  women  giving  birth  every  year.  The  number  of  perinatal  HIV  transmissions  dropped  to  69  (1.8/100,000  live  births)  in  2013  from  216  (5.4/100,000  live  births)  in  2002.  From  1994  to  2010,  the  CDC  estimates  that  almost  22,000  perinatally  acquired  were  prevented  by  the  use  of  antiretroviral  medications.  This  favorable  trend  correlates  with  more  pregnant  women  being  tested  and  the  expanded  use  of  antiretroviral  drugs;  however,  63%  of  the  infected  mothers  were  African  American  and  18.3  were  Latino  suggesting  targeted  interventions  may  decrease  the  perinatal  ­infection  rate  even  more.  See  Fig.  26-1.