Serosurvey of human immunodeficiency virus infection in parturients. Implications for human immunodeficiency virus testing programs of pregnant women

JAMA. 1987 Nov 20;258(19):2701-3.

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.

KIE: The authors were interested in determining the prevalence of human immunodeficiency virus (HIV) seropositivity in childbearing women from a population with a high incidence of AIDS. They collected cord blood samples from 602 newborns delivered at Brooklyn's Kings County Hospital Center, a facility serving an inner-city minority population. Twelve of the samples tested positive for HIV. In interviews, seven of the seropositive mothers revealed risk factors for AIDS, while five had no self-identified risk factors. The authors conclude that HIV infection of women of childbearing age in the inner cities is prevalent enough to justify offering HIV testing to all pregnant women in these areas. They suggest that hospitals throughout the country conduct serosurveys and use the information obtained to create counseling and testing programs for women of childbearing age.

MeSH terms

  • Enzyme-Linked Immunosorbent Assay
  • Female
  • Fetal Blood / immunology*
  • HIV Seropositivity / epidemiology*
  • Humans
  • Immunologic Techniques
  • Infant, Newborn
  • Mass Screening
  • New York City
  • Pregnancy
  • Pregnancy Complications, Infectious / epidemiology*
  • Pregnant Women*
  • Risk Factors
  • Vulnerable Populations*