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HIV Among Pregnant Women, Infants and Children in the United States

March 23, 2016

Fast Facts
  • All women who are pregnant or planning to get pregnant should get tested for HIV as early as possible.
  • If a woman is treated for HIV early in her pregnancy, the risk of transmitting HIV to her baby can be 1% or less.
  • With current treatment, many people who have perinatal HIV are living long into adulthood.


HIV Among Pregnant Women, Infants and Children

Perinatal HIV, also known as mother-to-child transmission, can happen at any time during pregnancy, labor, delivery, and breastfeeding. CDC recommends that all women who are pregnant or planning to get pregnant take an HIV test as early as possible before and during every pregnancy. This is because the earlier HIV is diagnosed and treated, the more effective HIV medicines, called antiretroviral treatment (ART), will be at preventing transmission and improving the health outcomes of both mother and child.

Advances in HIV research, prevention, and treatment have made it possible for many women living with HIV to give birth without transmitting the virus to their babies. HIV infections through perinatal transmission have declined by more than 90% since the early 1990s, while the number of HIV-infected women giving birth has increased. Today, if a woman takes HIV medicines exactly as prescribed throughout pregnancy, labor, and delivery, and provides HIV medicines to her baby for 4-6 weeks, the risk of transmitting HIV can be 1% or less. In some cases, a Cesarean delivery can also prevent HIV transmission. After delivery, a mother can prevent transmitting HIV to her baby by not breastfeeding and not pre-chewing her baby's food.

Women who are HIV-negative but have an HIV-positive partner should talk to their doctor about taking HIV medicines daily, called pre-exposure prophylaxis (PrEP), to protect themselves while trying to get pregnant, and to protect themselves and their baby during pregnancy and while breastfeeding.


The Numbers

HIV and AIDS Diagnoses


Living With HIV


Deaths


Rates (per 100,000 Live Births) of Perinatally Acquired HIV Infections by Year of Birth and Mother's Race/Ethnicity, 2008-2012

Rates (per 100,000 Live Births) of Perinatally Acquired HIV Infections by Year of Birth and Mother's Race/Ethnicity, 2008-2012

Note: Data include only persons born in the United States.

Source: CDC. Monitoring selected national HIV prevention and care objectives by using HIV surveillance data -- United States and 6 dependent areas -- 2013. HIV Supplemental Surveillance Report 2015;20(2).


Prevention Challenges


What CDC Is Doing

child and pregnant mother's belly

Additional Resources

Bibliography

  1. Townsend CL, Cortina-Borja M, Peckham CS, de Ruiter A, Lyall H, Tookey, PA. Low rates of mother-to-child transmission of HIV following effective pregnancy interventions in the United Kingdom and Ireland, 2000-2006. AIDS 2008;22(8):973-81.
  2. CDC. Achievements in public health: reduction in perinatal transmission of HIV infection -- United States, 1985-2005. MMWR 2006;55(21):592-97.
  3. CDC. Diagnoses of HIV infection in the United States and dependent areas, 2014. HIV Surveillance Report 2015;26.
  4. Fleming PL, Lindegren ML, Byers R, et al. Estimated number of perinatal HIV infections, U.S., 2000. Poster Exhibition: XIV International AIDS Conference. Barcelona, Italy. 2002 Jul 7-12;14: Abstract No. TuPeC4773. www.iasociety.org/Default.aspx?pageId=11&abstractId=7403.
  5. Whitmore SK, Zhang X, Taylor AW, Blair JM. Estimated number of infants born to HIV-infected women in the United States and five dependent areas, 2006. J Acquir Immune Defic Syndr 2011;57:218-22.
  6. Taylor AW, Little KM, Zhang X, et al. Estimated perinatal antiretroviral exposures, cases prevented and infected infants in the era of antiretroviral prophylaxis in the United States. 19th Conference on Retroviruses and Opportunistic Infections (CROI 2012). Seattle, WA. 2012 Mar 5-7; Abstract No. T-103: Poster 1000.
  7. CDC. Pediatric HIV surveillance (through 2011). Slide set. www.cdc.gov/hiv/library/slideSets/index.html.
  8. Valverde E, Short W, Brady K, Frazier E, Beer L, Mattson C.  HIV medical provider's assessment of the reproductive plans of women receiving HIV care: Medical Monitoring Project Provider Survey, 2009. 6th IAS Conference on HIV Pathogenesis, Treatment and Prevention (IAS 2011). Rome, Italy. 2011 Jul 17-20; Abstract No. TUPE307. http://pag.ias2011.org/Abstracts.aspx?AID=2197.
  9. Whitmore SW, Taylor AW, Espinoza L, Shouse FL, Lampe MA, Nesheim SR. Correlates of mother-to-child HIV transmission in the United States and Puerto Rico. Pediatrics 2012 Jan;129:e74-81.
  10. Taylor AW, Nesheim S, Whitmore S, et al. Estimated number and characteristics associated with perinatal HIV infections, 33 states, United States, 2003-2007. 6th IAS Conference on HIV Pathogenesis, Treatment and Prevention (IAS 2011). Rome, Italy. 2011 Jul 17-20; Abstract No. TUPDC0103. www.iasociety.org/Default.aspx?pageId=11&abstractId=200743287.
  11. CDC. Monitoring selected national HIV prevention and care objectives by using HIV surveillance data -- United States and 6 dependent areas -- 2013. HIV Surveillance Supplemental Report 2015;20(2).  
  12. CDC. Revised recommendations for HIV testing of adults, adolescents, and pregnant women in health-care settings. MMWR 2006;55(RR-14):1-17.
  13. Panel on Treatment of HIV-Infected Pregnant Women and Prevention of Perinatal Transmission. Recommendations for use of antiretroviral drugs in pregnant HIV-1-infected women for maternal health andinterventions to reduce perinatal HIV transmission in the United States; 2012 Jul 31:1-235. http://aidsinfo.nih.gov/contentfiles/lvguidelines/perinatalgl.pdf. Accessed August 17, 2012.
  14. Barrow RY, Newman LM, Douglas JM Jr. Taking positive steps to address STD disparities for African American communities. Sex Transm Dis 2008;35(12 Suppl):S1-S3.
  15. Gaur AH, Dominguez KL, Kalish ML, et al. Practice of feeding premasticated food to infants: a potential risk factor for HIV transmission. Pediatrics 2009;124:658-66.
  16. Lampe MA, Smith DK, Anderson GJ, Edwards AE, Nesheim SR. Achieving safe conception in HIV-discordant couples: the potential role of oral preexposure prophylaxis (PrEP) in the United States. Am J Obstet Gynecol 2011;204:488.e1-8.


Other Resources

Event: National Women and Girls HIV/AIDS Awareness Day

Slide set: HIV Surveillance in Women

MMWR article: HIV, Other STD, and Pregnancy Prevention Education in Public Secondary Schools -- 45 States, 2008-2010

AIDS Alliance for Children, Youth, & Families

Mother to Child Transmission Resources (AIDS Education and Training Centers)

STDs & Pregnancy 

HIV/AIDS (womenshealth.gov)

Women, Children, and HIV (University of California, San Francisco)

Cervical Cancer and HIV (SmartGlobalHealth.org)

Pregnancy and HIV, Viral Hepatitis, STD, and TB Prevention


Footnotes

  1. 13 years of age and younger.
  2. Hispanics/Latinos can be of any race.
  3. Includes deaths from any cause.




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