U.S. Public Health Service Recommendations for Human Immunodeficiency Virus Counseling and Voluntary Testing for Pregnant Women

07-28-95 12:25PM FROM DHHS-OASIH/OC TO 916199424979 P009/010
Vol.44 / No. RR-7 MMWR
U.S. Public Health Service Recommendations
for Human Immunodeficiency Virus Counseling and
Voluntary Testing for Pregnant Women
Summery
These recommendations were developed by the U.S. Public Health Service to
address the increasing epidemic of human immunodficivrcy virus (HV) infection among women and their infants. The recommendations stress the
importance of early diagnosis of HIV infection for the health of both women and
their infants and are bowed on advances made in HIV-related treatment and prevention. The most significant advance for this population has been the results
from a placebo-controlled, clinical trial that indicated that administration of zidovudine to HIV-infected pregnant women and their newborns reduced the risk
for perinetal transmission of HIV by approximately two thirds (1). This document recommends routine HlVcounseling and voluntary testing for all prognant
women and is intended to serve as guidance for health-care providers in educating women about the importance of knowing their HIV infection status. For
""'bninfected women, qsuch HIV counseling and testing program. can provide information that can reduce their risk for acquiring HIV; for women who have HIV
infection, these programs can enable them to receive appropriate and timely
medical interventions for their own health and for eeducing the risk for perinarel
(.e., mother to infant; and other modes of HIV transmission. These programs
also can facilitate appropriate follow-up care and services for HIV-infected
women, their infants, and other family members.
INTRODUCTION
During the past decade, human immunodeficiency virus (HIV) infection has become a leading cause of morbidity and mortality omong women, the population
accounting for the most rapid increase in cases of acquired immunodeficiency syndrome (AIDS) in recent years. As the incidence of HIV infection has increased among
women of childbearing age, increasing numbers of children have become infected
through perinatal (i.e., mother to infant) transmission; thus, HIV infection has also become a leading cause of death for young children. To reverse these trends, HIV
education end services for prevention and health care must be made available to all
women. Women who have HIV infection or who are at risk for infection need access to
-- iftfiit information regardig-A) eady-intvrventions to 4mprovW'*N~ival ras'hfdt
quality of life for HlV*infecte0 persons, b) strategies to reduce the risk for perinatal "IV
transmission, end c) management of HVinfection in pregnant women and perinatally
exposed or infected children. Results from a randomized, placebo-controlled clinical
trial have indicated that the risk for perinatal HIV transmission can be substantially
reduced by administration of zidovudine (ZDV (also referred to as AZT) to 14Vinfected pregnant women and their newborns (1). To optimally benefit from this therapy, lIY-infection must be diagnosed in these women before or during early
pregnancy.