In a recent study published in Pediatrics, researchers have highlighted significant inadequacies in the prevention of HIV transmission from mothers to newborns in the United States. The analysis revealed that over half of the newborns diagnosed with HIV within their first year of life had not received the necessary preventive treatment. This situation points to a critical gap in identifying HIV-positive pregnant women early in their pregnancies. Kengo Inagaki, a pediatric infectious diseases physician at the University of Michigan, emphasizes the urgent need for improved maternal HIV detection protocols to prevent such cases.
The standard approach involves testing for HIV in the first trimester of pregnancy, with a follow-up test in the third trimester, typically only for high-risk women or in regions with higher HIV rates. If a mother tests positive, she undergoes an antiviral regimen to reduce her viral load. In cases where the viral load remains high, a Cesarean section may be performed to minimize transmission risks. After birth, newborns receive a combination of three HIV antiretroviral drugs, which dramatically decrease the risk of transmission from 25% to less than 1%.
The study, which analyzed Medicaid records for over 3 million babies born between 2009 and 2021, found that of the 52 cases of HIV diagnosed in infants after one year, 27 had not been given the preventive treatment. This indicates that maternal infections were missed at a critical point. Disparities are also evident, as Black infants represented a disproportionate 74% of those who did not receive the prophylaxis, highlighting inequities in healthcare access and outcomes.
Despite the small size of the study, the findings underscore the devastating impact HIV can have on families and the importance of prevention. The three-drug combination therapy has significantly reduced perinatal HIV rates in the U.S., dropping from 1,610 cases in 1990 to fewer than 200 cases annually in recent years. Given that women of childbearing age constitute a large proportion of those diagnosed with HIV in the U.S., the implications of these findings are critical.
To combat this issue, Inagaki advocates for universal third-trimester testing for maternal HIV, as opposed to the current risk-based approach. This strategy could facilitate timely treatment and reduce the likelihood of HIV transmission to infants, ultimately protecting their health and wellbeing. The study’s results call for immediate policy changes to improve maternal healthcare practices and ensure that all pregnant women undergo adequate HIV screening.
The significance of this issue is further amplified by the necessity of supporting science journalism and promoting scientific literacy among the general public. As decisions affecting public health are increasingly informed by scientific understanding, the role of media in translating this complex information becomes vital. Organizations such as Science News aim to enhance this understanding and advocate for marginalized populations affected by these public health challenges.
