Reconsidering the Number of Women With HIV Infection Who Give Birth Annually in the United States

Abstract

Objectives: The annual number of women with HIV infection who delivered infants in the United States was estimated to be 8700 in 2006. An accurate, current estimate is important for guiding perinatal HIV prevention efforts. Our objective was to analyze whether the 2006 estimate was consistent with the number of infants with HIV infection observed in the United States and with other data on perinatal HIV transmission. Methods: We compared the number of infants born with HIV in 2015 (n ¼ 53) with data on interventions to prevent perinatal HIV transmission (eg, maternal HIV diagnosis before and during pregnancy and prenatal antiretroviral use). We also estimated the annual number of deliveries to women living with HIV by using the number of women of childbearing age living with HIV during 2008-2014 and the estimated birth rate among these women. Finally, we determined any changes in the annual number of infants born to women with HIV from 2007-2015, among 19 states that reported these data. Results: The low number of infants born in the United States with HIV infection and the uptake of interventions to prevent perinatal HIV transmission were not consistent with the 2006 estimate (n ¼ 8700), even with the best uptake of interventions to prevent perinatal HIV transmission. Given the birth rate among women with HIV (estimated at 7%) and the number of women aged 13-44 living with HIV during 2008-2014 (n ¼ 111 273 in 2008, n ¼ 96 363 in 2014), no more than about 5000 women with HIV would be giving birth. Among states consistently reporting the annual number of births to women with HIV, the number declined about 14% from 2008 to 2014. Conclusion: The current annual number of women with HIV infection delivering infants in the United States is about 5000, which is substantially lower than the 2006 estimate. More accurate estimates would require comprehensive reporting of perinatal HIV exposure.

Prediction of Maternal and Fetal Pharmacokinetics of Dolutegravir and Raltegravir Using Physiologically Based Pharmacokinetic Modeling

“…The recommendation to provide all pregnant women living with HIV with antiretroviral therapy (ART) has had a major impact on the prevention of vertical transmission of HIV in the United States (U.S.) and globally. The incidence rate for perinatally acquired HIV infection in the U.S. has decreased from over 5% in 2002 to about 2% in 2013 and to 53 cases in 2015 [1,2]. The goal of the U.S. Center for Disease Control and Prevention is the complete elimination of perinatal HIV transmission [3].…”

HIV testing among pregnant women with prenatal care in the United States: An analysis of the 2011–2017 National Survey of Family Growth

“…About 5000 women living with human immunodeficiency virus (HIV) are estimated to give birth annually in the United States. 1 However, some of these women are not aware of their HIV status, 2 and they go through prenatal care, labor, and delivery without being diagnosed, resulting in missed opportunities for preventing mother-to-child transmission of HIV with antiretroviral drugs. 3–5 While there has been significant progress in reducing perinatal HIV transmission, the United States is yet to meet the proposed elimination goal of less than one infection per 100,000 live births.…”

Trends in HIV-2 Diagnoses and Use of the HIV-1/HIV-2 Differentiation Test — United States, 2010–2017

“…Moreover, HIV-2 infection results in lower levels of circulating virus compared with those of HIV-1 infection. Finally, evidence of pregnancy in women with HIV infection is underreported to NHSS (10). Although this can result in an underestimation of the number of pregnant women with HIV-2, reporting of perinatal HIV infection is robust, thus increasing the likelihood that perinatal HIV-2 infection would have been recognized.…”