Reducing the Odds: Preventing Perinatal Transmission of HIV in the United States

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Thousands of HIV-positive women give birth every year. Further, because many pregnant women are not tested for HIV and therefore do not receive treatment, the number of children born with HIV is still unacceptably high. What can we do to eliminate this tragic and costly inheritance? In response to a congressional request, this book evaluates the extent to which state efforts have been effective in reducing the perinatal transmission of HIV. The committee recommends that testing HIV be a routine part of prenatal care, and that health care providers notify women that HIV testing is part of the usual array of prenatal tests and that they have an opportunity to refuse the HIV test. This approach could help both reduce the number of pediatric AIDS cases and improve treatment for mothers with AIDS.
Reducing the Odds will be of special interest to federal, state, and local health policymakers, prenatal care providers, maternal and child health specialists, public health practitioners, and advocates for HIV/AIDS patients. January

 

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Contents

EXECUTIVE SUMMARY
1
INTRODUCTION
15
HIV Testing and Screening in the United States
30
NATURAL HISTORY DETECTION AND TREATMENT
45
IMPLEMENTATION AND IMPACT OF THE PUBLIC HEALTH
68
Strategies to Reduce Perinatal HIV Transmission
104
Incorporating Universal Routine HIV Testing into
113
Resources and Infrastructure
122
INDEX
227
Thoughts from
275
19871997
313
Introduction 1
356
Recommendations 8
363
Single copies of this document are available from the Centers for Disease Control
371
Acronyms and Glossary
372
286
381

Population Groups That May Face Additional Barriers
131
A Committee and Staff Biographies
147
B Context of Services for Women and Children Affected
155

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