Annual HIV Summary Report 1998 Edition Introduction
The Program
The Comprehensive Newborn Screening Program began mandatory HIV testing February 1, 1997. Data are available from newborn blood specimens tested by the Department of Health Wadsworth Laboratory for 250,834 women giving birth from January 1, 1998 to December 31, 1998. Of these, 996 women (0.40%) tested abnormally, via their newborn's tests, for the presence of HIV antibodies. Approximately 94 percent of the abnormal tests were definitely positive for HIV antibodies while the remaining 6 percent had indeterminate results. The presence of HIV antibodies indicates that the mother is HIV infected and the infant may or may not be infected. Studies suggest that approximately 25 percent of infants, born to HIV-infected mothers who receive no HIV prophylaxis, are themselves infected.The perinatal infection rate is reduced by two-thirds with a three-part regimen of antiretroviral prophylaxis.
To determine the HIV prevalence among childbearing women, data from the Comprehensive Newborn Screening Program was obtained on all single births and the first infants of multiple births for whom a suitable specimen was provided.This information included maternal age and residence of birth and the race/ethnicity of the infant.
Seroprevalence
HIV seroprevalence in childbearing women varied by geographic area, age and racial/ethnic group.The highest prevalence was detected among childbearing women in New York City, with 0.71 percent or one in 141 women giving birth testing positive. Women giving birth from elsewhere in the state had a prevalence of 0.13 percent, approximately one in 769 women giving birth testing abnormal.
HIV seroprevalence increased with increasing maternal age from 0.22 percent for those 10 to 19 years of age to 0.34 percent for those 20 to 24 years of age, 0.39 percent for those 25 to 29 years of age, 0.45 percent for those 30 to 34 years of age, and 0.49 percent for those 35 years of age or older.
HIV seroprevalence also differed by race or ethnicity of the infant. Black or Hispanic infants represented 37 percent of all infants, but 88 percent of those testing abnormally for HIV antibodies.The infants' HIV prevalence by race or ethnicity was 1.32 percent or one in 76 for blacks, 0.55 percent or one in 182 for Hispanics, and 0.06 percent or one in 1,667 for whites.
Testing History
Maternal HIV testing history is assessed at delivery by chart review or maternal response. There are four categories of response labeled A, B, C and D. A fifth category "Missing" exists if maternal HIV testing history is not recorded.
The mother's HIV test experience is described in the following categories:
- Tested during this pregnancy
- Tested prior to this pregnancy
- Not previously tested
- Test history unknown
The maternal HIV testing history category called "Not Previously Tested" indicates those women whose HIV status was not known at delivery due to nonexistent testing. Women who have been tested and the results are unknown at delivery and women unable to give a response to this question are reflected in the category "Unknown". Department of Health regulations, to be effective on August 1, 1999, require birth facilities and attendants to provide expedited HIV testing in the labor/delivery/nursery setting to women who have not been tested during this pregnancy or to their newborns.
Maternal HIV testing history varied by geographic area, age and racial or ethnic group. The percent of women tested for HIV during pregnancy in this reporting period was higher for women residing in New York City at 62 percent, compared to 48 percent for women residing elsewhere in the state, and 37 percent for women of unknown or out of state residence.
The percent of women who were tested for HIV during pregnancy decreased with age. The testing rate was 76 percent for women 10 to 19 years of age, 66 percent for women 20 to 24 years of age, 55 percent for women 25 to 29 years of age, 46 percent for women 30 to 34 years of age, and 43 percent for women 35 years of age or older.
The percent of those infants for which data are available and whose mothers were tested for HIV during pregnancy was 77 percent for Hispanics, 69 percent for blacks, and 41 percent for whites.
Caution
Data are reported by geographic area based on mother's county of residence except for the table "Hospitals by Location". This table reflects the county in which the facility is located.
Data on maternal HIV testing history could have been self-reported and have not been verified by Department of Health chart review although a validation study is underway. In addition, data on maternal HIV testing history do not necessarily reflect the prenatal HIV counseling and testing success of the hospital of birth as women often receive prenatal care at other sites