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Perinatal transmission from mother to child accounts for 95% of pediatric AIDS cases in Chicago and 90% in Illinois. Although pediatric HIV infection is now managed as a chronic illness with life expectancy that can extend into adolescence and beyond, it is a fatal disease causing significant human suffering and financial costs (more than $10,000/year). Most importantly, transmission of HIV infection from mother to child can be prevented.
A major breakthrough in the prevention of HIV transmission occurred in 1994 when a standard of care for routine prenatal HIV testing of all pregnant women was established as an outcome of a National Institutes of Health (NIH) study. The study found that if pregnant women are identified as HIV-positive before giving birth and administered antiretroviral therapy during pregnancy, delivery and to the newborn in the first 6 weeks of life, the transmission of the virus to the newborn is reduced by two thirds. Although great progress has been made in advancing routine prenatal HIV testing in Illinois, up to 25% of pregnant women do not undergo HIV testing. Accordingly, only a 45% reduction in transmission has been documented in Chicago to date.
Routine prenatal HIV testing offers the most effective method of reducing HIV transmission from mother to newborn. However, recent scientific studies showed that if antiretroviral therapy is given ONLY to the newborn in the first 48 hours of life, more than a third of the children born to unidentified HIV-infected mothers will be prevented from acquiring HIV disease. To achieve this outcome, they must be identified and administered prophylactic treatment within the first 24 to 48 hours of birth. Newborn HIV testing also offers the opportunity to provide HIV-infected newborns with early medical care that will prevent significant suffering and premature death.