Los Angeles County Issues Public Alert for Pregnant Women to be Tested for HIV After Seven Newborns Infected in January

Los Angeles County health officials on Monday issued a public alert "urging" pregnant women to be tested and treated for HIV infection to prevent vertical transmission of the virus, after seven new HIV cases among infants were reported in the county last month, the Los Angeles Times reports. Some of the mothers of the seven HIV-positive children received no prenatal care, some had turned down HIV tests offered during prenatal visits and others said they had tested negative for HIV. HIV-positive women can reduce the risk of HIV transmission to their newborns to less than 8% by taking antiretroviral drugs during pregnancy and avoiding breastfeeding, Dr. Toni Frederick, chief epidemiologist for Los Angeles County's pediatric HIV project, said. Women who are incarcerated, homeless, non-English speakers, undocumented immigrants, uninsured, drug users or teenagers were less likely to receive prenatal care and HIV tests, according to Los Angeles County Public Health Director Dr. Jonathan Fielding. Even if an HIV-positive woman receives no prenatal care, hospitals can take steps to prevent vertical HIV transmission by providing drugs to the mother during delivery or to the infant during the first 24 hours after birth, but only if a woman is identified as HIV-positive during childbirth or "immediately afterward." Outreach efforts by Los Angeles County-USC Medical Center have been "success[ful]," as none of the 200 HIV-positive women who received prenatal care at the hospital during the last five years gave birth to an HIV-positive infant, the Times reports. However, Andrea Kovacs, head of the hospital's program for HIV-positive women, said she was "troubled" by one case in which HIV test results came back "too late" to prevent transmission to the newborn and would like to start offering "rapid testing" for HIV that could provide test results in only an hour, compared to the current test's four days. California doctors are required to counsel pregnant women about HIV and offer an HIV test, but the women "have the right to refuse." Some states, like New York, require that hospitals test newborns for HIV, even without the mother's consent. Four or five perinatal HIV infections were reported in Los Angeles County each year from 1998 to 2001, the Times reports (Ornstein, Los Angeles Times, 2/5).