Annual Summary Report 1997 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 226,095 women giving birth from February 1, 1997 to December 31, 1997. Of these, 923 women (0.41%) tested positive, via their newborn's tests, for the presence of HIV antibody. The presence of HIV antibody 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 and without medical intervention, are themselves infected. The perinatal infection rate with antiretroviral therapy is reduced by two thirds.
Seroprevalence
HIV prevalence 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 0.76 percent or one in 132 women giving birth testing positive. Previous ZIP code analysis of the childbearing women in New York City showed a close correlation between areas of HIV positivity and areas of known prevalent drug use. Women giving birth from elsewhere in the state had a prevalence of 0.12 percent, approximately one in 865 women giving birth testing positive.
For childbearing women whose age was identified, the percent of HIV seropositivity increased with age. The percent of HIV seropositive childbearing women was: 0.31 percent for those 10 to 19 years of age, 0.39 percent for those 20 to 24 years of age, 0.40 percent for those 25 to 29 years of age, 0.43 percent for those 30 to 34 years of age, and 0.46 percent for those 35 years of age or older.
For childbearing women whose infants' ethnicity or race were identified, black or Hispanic infants constituted 36 percent of all first infants for childbearing women delivering in this time period but 89 percent of the HIV antibody positive infants. The statewide prevalence in infants for which data are available by race or ethnicity was 1.39 percent or one in 73 for blacks, 0.63 percent or one in 159 for Hispanics, and 0.06 percent or one in 1,580 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 is 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". The testing history category "Not Previously Tested" indicates the number of women and their exposed infants to be assisted by rapid testing and increased outreach.
Maternal HIV testing history varied by geographic area, age and racial or ethnic group. The percent of women tested for HIV during or prior to pregnancy in this reporting period was higher for women residing in New York City at 67 percent, followed by 63 percent for women residing elsewhere in the state, and 54 percent for women of unknown or out of state residence.
The percent of women whose age was known and who were tested for HIV during or prior to this pregnancy decreases with age. The testing rate was 78 percent for women 10 to 19 years of age, 72 percent for women 20 to 24 years of age, 64 percent for women 25 to 29 years of age, 60 percent for women 30 to 34 years of age, and 57 percent for women 35 years of age or older.
The percent of first infants whose race or ethnicity was known and whose mothers were tested for HIV during or prior to pregnancy was 78 percent for Hispanics, 77 percent for blacks, and 57 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 are 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 case at other sites.
