Overview

Welcome to the first issue of Perinatal HIV Prevention: National Update. You are receiving this newsletter because you expressed an interest in perinatal HIV prevention in hospitals. This free, quarterly email newsletter will connect its subscribers to news updates, trends, statistics, prevention programs, policy initiatives, tools, and useful practices relating to perinatal HIV prevention in US hospitals. The dramatic reduction of perinatal HIV transmission in the US stands as one of the great public health successes in US history. But in spite of this success, there are still women – and babies – that slip through the cracks. Our nation’s hospitals stand in a unique position to implement practices and policies that can make a real difference in the lives of these women and babies. The Health Research and Educational Trust (HRET), with support from the Centers for Disease Control and Prevention, launches this newsletter as a forum for information dissemination and for communication among and between hospital staff, HIV experts, and researchers.

For more information on HRET’s Perinatal HIV Prevention project, please visit the perinatal HIV website.

If you have comments or suggestions for future issues of this newsletter, please contact Jennifer Reiter at jreiter2@aha.org.

November 18^th CDC Satellite WebCast on Rapid Testing for HIV Prevention Hospital staff are encouraged to participate in this live CDC broadcast and web cast on Thursday, November 18^th from 1-3 pm ET. This webcast will provide information regarding the availability and administration of rapid tests for HIV, and will address implementation considerations such as providing counseling, testing women in labor, obtaining CLIA certification, establishing a quality assurance program and training health care providers. Click here for more information

CDC Model Protocol: Rapid HIV Antibody Testing During Labor And Delivery For Women of Unknown HIV Status

Hospitals stand in a unique position to achieve complete elimination of perinatal HIV transmission in the US by practicing routine rapid HIV testing during labor and delivery for women of unknown HIV status, and subsequent treatment of women testing positive and their infants. Effective interventions dramatically reduce the rate of perinatal HIV transmission when women are identified as HIV-infected early in pregnancy. HIV-infected pregnant women who do not receive prenatal care or do not receive an HIV test during prenatal care are not identified as being infected and therefore represent missed opportunities to reduce the risk of transmission to their infants and to receive life-saving treatments for themselves. With the implementation of screening programs using rapid HIV testing in labor and delivery settings, women with unknown HIV test results during prenatal care can learn their HIV status quickly and receive short-course antiretroviral (ARV) prophylaxis to reduce the risk of transmitting HIV to their infants. The Centers for Disease Control and Prevention (CDC) recommends routine rapid HIV testing using an opt-out approach for women in labor whose HIV status is unknown. The CDC has developed a model protocol for hospitals to incorporate routine rapid testing into their labor and delivery practices. Please click here to access this protocol.

Enhanced Perinatal HIV Surveillance – United States, 1999-2001

This CDC report describes the population of HIV-infected women who gave birth during the years 1999, 2000, and 2001. These data provide essential information for further focusing perinatal prevention efforts in the United States. The data are presented by child’s birth year so that readers can understand the characteristics of this population in a particular year. However, readers are cautioned against comparing the data for the birth years, as not all sites contributed data for all 3 years. Please click here for the report.

Preventing Perinatal HIV Transmission: Rapid Testing in Labor & Delivery

Regional Strategic Planning Meetings for Hospitals

The CDC has made the further decrease of perinatal HIV transmission one of its priorities in advancing HIV prevention (MMWR, Vol 52, No. 15). CDC’s Division of HIV/AIDS Prevention is sponsoring a series of 1 ½ day regional workshops across the country to increase the capacity of hospitals and healthcare providers to offer rapid HIV testing to women in labor whose HIV serostatus is unknown. CDC is collaborating with the François-Xavier Bagnoud Center (FXBC) at the University of Medicine & Dentistry of New Jersey and the Agency for Economic Development (AED) to conduct these workshops.

These regional invitational meetings are scheduled in early 2005 for Los Angeles, Houston, Indianapolis, Raleigh, NC and Providence, Rhode Island. For further information, please contact Elaine Gross at (973) 972-5324 or at grossej@umdnj.edu

New ACOG Perinatal HIV Materials

The American College of Obstetricians and Gynecologists (ACOG) has developed and recently distributed "New Perinatal HIV Guidelines," a packet of materials to assist obstetric providers to incorporate or increase HIV testing and treatment for all pregnant patients. The packet contains a newly revised tear-off notepad HIV and Other Important Pregnancy Tests and a laminated information card Physician Information on HIV Testing that includes a suggested script that providers can use to notify patients about prenatal HIV testing. In addition to other professional guidance and patient educational materials on perinatal HIV, the packet also contains a new Committee Opinion Prenatal and Perinatal HIV Testing: Expanded Recommendations that includes ACOG's recommendations for repeat testing in third trimester and rapid HIV testing at labor and delivery. For additional information you may visit the ACOG website at http://www.mmsend2.com/link.cfm?r=12873570&sid=1226674&m=63037&u=AHA_HRET&s=http://www.acog.org/ or http://www.mmsend2.com/link.cfm?r=12873570&sid=1226675&m=63037&u=AHA_HRET&s=http://sales.acog.org/.

HRET Perinatal HIV Prevention Project Advisory Committee Members

HRET has assembled a multidisciplinary advisory group of maternal and child health experts who will provide direction in the development of hospital specific tools to increase perinatal HIV prevention practices. The advisory committee will examine and propose solutions to broad crosscutting policy issues related to perinatal HIV prevention including HIV testing, counseling, and patient education efforts in various hospital and acute healthcare settings. HRET has obtained advisors who are practitioners and researchers in maternal fetal medicine, obstetrics & gynecology, health policy, nursing, HIV provider training, epidemiology, hospital administration, laboratories, and pharmacology. Click here for the list of the HRET Perinatal HIV Prevention Project Advisory Committee Members.

HRET Hospital Perinatal HIV Testing Survey

Many thanks to all hospital representatives who took the time to complete the HRET Hospital Perinatal HIV Testing Survey this past summer. Over 1,200 hospitals responded to this survey, providing HRET with an unprecedented opportunity to understand current policies and practices that hospitals are employing to reduce perinatal HIV transmission in their patients. HRET is currently analyzing this data in preparation for the dissemination of results in 2005. This data will also inform the development of hospital specific tools to incorporate routine rapid HIV testing in labor and delivery settings for women of unknown HIV status. For more information on the perinatal HIV survey, please contact Jennifer Reiter at jreiter2@aha.org.