State Sees Dramatic Decline in Maternal/Child HIV Transmission
Health Commissioner Cites Requirement to Notify Mothers of Newborn Screening Results, Emphasis on Prenatal HIV Counseling and Testing
Albany, February 11, 2002 — State Health Commissioner Antonia C. Novello M.D., M.P.H., Dr.P.H. today said that the rate of perinatal HIV transmission in New York has declined dramatically in the wake of requirements that all pregnant women in the State receive HIV counseling and that new mothers be told the results of their infants' HIV tests.
In Governor Pataki's 1999 State of the State address, he set a goal of reducing the rate of HIV infection among babies to below five percent at the end of five years. Because of the Governor's leadership, laws and policies are now in place that have helped to dramatically reduce the rate of AIDS transmission from mothers to babies during pregnancy, childbirth or as the result of breast feeding.
"Before Governor Pataki took office, an estimated 25 percent of babies born to HIV-positive mothers were infected with HIV. Since the Governor signed the newborn HIV screening law, and supported crucial prevention initiatives, the rate of maternal/child HIV transmission in New York has dropped to an all-time low of 3.5 percent," Dr. Novello said. "Now we are committed to bringing the rate even lower, because these are not just statistics, they are our children."
Prior to the change in the law which was effective in February 1997, all newborns in New York State were screened for HIV antibodies, but the results were "blinded," meaning they were kept only for purposes of tracking the HIV epidemic, and were not provided to mothers. Although the presence of HIV antibodies does not necessarily mean that a newborn is HIV-positive, it does mean that the child's mother is infected. Because HIV can be transmitted in breast milk, some women who did not know their HIV status may have infected their newborns through nursing. Other women, whose babies were already infected at birth, delayed getting them treated for HIV because they were unaware of their child's illness. Left untreated, HIV infection in infants rapidly progresses to full-blown AIDS.
With the unblinding of HIV newborn screening results, and as the result of other State initiatives, the rate of perinatal HIV transmission has declined every year. One year after the law took effect it 1997, the rate dropped to 8.4 percent and in 1999 the rate fell to 6.9 percent. Preliminary data for 2000 show the perinatal HIV transmission rate at 3.5 percent – more than meeting the ambitious goal set by Governor George Pataki.
Governor Pataki said, "Three years ago I challenged our State to cut the rate of perinatal HIV transmission by more than half, to five percent within five years. I'm proud of these results but I'm even more grateful that because of our efforts lives are being saved, and children are being given the opportunity to grow up healthy and strong, free from the ravages of an incurable illness."
State Senator Guy J. Velella said, "When Assemblywoman Mayersohn and I proposed this law along with then Senator Pataki, many claimed that it would have absolutely no effect. I am proud to say they were wrong. This is one law we passed that directly saved the lives of New Yorkers."
Assemblywoman Nettie Mayersohn, who authored the newborn HIV screening law in the Assembly, said, "I'm very grateful to the Governor, not only because he understood the importance of this legislation, but he and his administration have implemented it so successfully that it may become the basis for a national model."
Since August 1999, State Health Department regulations also require that any women who presents for delivery and has not had an HIV test during her current pregnancy be counseled about the importance of knowing her HIV status and offered an HIV test. For pregnant women who decline or are unable to have an HIV test during labor, the law requires their babies be tested for HIV immediately after birth, with the results back as soon as possible but no later than 48 hours after the specimen is collected. This "expedited testing" allows therapy to be given during labor or to the baby immediately after birth to prevent HIV transmission. It also increases the likelihood that mothers will know screening results before they leave the hospital allowing them to make informed decisions about breast feeding and whether to seek follow-up HIV care for themselves and their infants.
HIV testing during pregnancy and prenatal care is vital. Research has shown that HIV-positive women who receive anti-retroviral therapy during childbirth are less likely to transmit HIV infection to their infants. If anti-retroviral drugs are given during pregnancy, the woman stays healthier and the risk to her baby is lower still. HIV-positive women who know their status early in their pregnancy may also decide to deliver by Cesarian section, another way to reduce the risk of perinatal HIV transmission.
Currently, the State Health Department is conducting a Community Action for Prenatal Care (CAPC) campaign, targeted at communities at high risk for HIV to identify pregnant women who lack prenatal care and get them into treatment.