State Health Department Success in Reducing Mother-to-Child HIV Transmission Highlighted in Public Health Journal

ALBANY, N.Y. (October 18, 2010) - The New York State Department of Health's (DOH) success in achieving a significant reduction in mother-to-child (perinatal) transmission of HIV is chronicled in two companion papers that appear in the November/December 2010 issue of the Journal of Public Health Management and Practice.

The journal has posted the two articles for public viewing on its web site at: www.jphmp.com.

Due to the implementation of State policy measures and the work of health care providers and community-based agencies throughout New York State, the rate of perinatal HIV transmission in New York State fell from 11.5 percent at the beginning of the program in 1997 to 1.3 percent in 2008. The journal highlights the unique and comprehensive program launched by the State in 1997 to prevent perinatal transmission of the virus.

"HIV prevention continues to be a public health priority, including preventing transmission of HIV from childbearing women to their infants," said State Health Commissioner Richard F. Daines, M.D. "I am proud of the Department's work to prevent mother-to-child transmission of HIV and reduce the number of HIV and AIDS cases in New York. The progress that has been made, especially in preventing perinatal transmission, reflects the concerted efforts of the Department's AIDS Institute, Center for Community Health, and Wadsworth Center laboratory, as well as countless front-line health and human service providers across the state."

Guthrie S. Birkhead, M.D., Deputy Commissioner of DOH's Office of Public Health, who has overseen activities to prevent perinatal transmission of HIV since 1995, said: "This work represents the combined efforts of obstetricians, hospitals, laboratories, professional medical societies, community-based organizations, and women living with HIV to eliminate this route of HIV transmission. These accomplishments are a testament to the dedicated efforts of everyone involved in this important work, and New York's approach to perinatal HIV prevention and newborn HIV testing."

AIDS Institute Director Humberto Cruz said: "These two papers highlight an important component of the AIDS Institute's response to HIV/AIDS in New York State. The creation of the AIDS Institute in 1983 was a vital step to combat HIV/AIDS, and as we look back on our successful efforts, we look ahead to building on our accomplishments to protect public health through prevention, early diagnosis and effective treatment."

By 1987, State health officials knew they were facing a major public health crisis when they discovered that one out of every 61 babies in New York State was born exposed to HIV. An estimated 25 percent to 30 percent of these babies were found to have been infected by transmission from their mothers.

Based on growing knowledge that antiretroviral medications could prevent mother-to-child transmission of HIV, it became imperative to know if a pregnant woman was infected with HIV so that preventive medicine could by administered. A multifaceted public health response was launched to increase the number of pregnant women tested for HIV. In the mid-1990s, only 50 percent of pregnant women knew their HIV status, but through intensive efforts by DOH and health care providers across the state, that number has topped 95 percent each year since 2003. At the same time, the proportion of HIV-infected mothers accessing prenatal care increased to nearly 97 percent

As a result, New York's perinatal HIV transmission rate declined to 1.3 percent in 2008, a major decrease from 11.5 percent in 1997 and an estimated rate of 25-30 percent prior to 1995. In 1997, 99 exposed infants in New York State were determined to be HIV infected, but in 2008, that number had dropped to six. In addition, by 2008, 93 percent of mothers with HIV and 99.7 percent of infants exposed to the disease were receiving antiretroviral prophylaxis to prevent HIV infection.

Two commentaries accompanying the journal articles described the progress in New York State as "a remarkable feat given the vulnerability and often difficult-to-reach population of HIV-infected women," but cautioned that "meeting the complex needs of HIV-infected children and adolescents remains challenging."

Journal Editor Lloyd Novick, M.D., M.P.H., who also chairs the Department of Public Health at Brody School of Medicine of East Carolina University, said, "The Journal of Public Health and Management Practice is pleased to publish such significant accomplishments of one of the leading public health agencies in the world."

Additional information about the AIDS Institute's role in preventing mother-to-child transmission of HIV can be found in the publication, "The New York State Department of Health AIDS Institute, July 30, 1983-July 30, 2008: 25 Years of Leadership, Service and Compassion," available on the DOH's web site: www.health.ny.gov.