Letter from the Director

Dear Colleague,

We are almost there! Today, pregnant women living with human immunodeficiency virus (HIV) can reduce the risk of perinatal transmission to 1% or less by taking antiretroviral medicines as prescribed throughout pregnancy, labor, and delivery, and by providing HIV medicines to their babies for 4-6 weeks. However, perinatal HIV transmission cannot be eliminated unless pregnant women are tested for HIV as early in the pregnancy as possible and linked to care if HIV-positive.

Identifying new cases is critical to stopping perinatal transmission of HIV. The Centers for Disease Control and Prevention (CDC) and the American College of Obstetricians and Gynecologists (ACOG) recommend that obstetricians test all pregnant patients for HIV, preferably in the first trimester. ACOG also affirms that early identification and treatment of all pregnant women with HIV is the best way to prevent neonatal infection and improve women’s health. For more information, please visit www.acog.org .

CDC has developed a new framework with the goal of eliminating perinatal HIV transmission in the United States. CDC defines elimination as a reduction of transmission to an incidence of fewer than 1 infection per 100,000 live births and to a rate of less than 1% among HIV-exposed infants.

In 2006, CDC released Revised Recommendations for HIV Testing of Adults, Adolescents, and Pregnant Women in Health-Care Settings. The revised recommendations endorsed including HIV screening in the routine panel of prenatal screening tests for all pregnant women unless the patient declines (opts out), and repeat screening in the third trimester in certain jurisdictions with elevated rates of HIV infection among pregnant women. To see the full recommendations, visit http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5514a1.htm .

Since 2008, obstetricians and gynecologists have been using CDC’s One Test. Two Lives.TM (OTTL) campaign to help encourage all of their pregnant patients to be tested for HIV. The OTTL campaign has recently been updated to include new tools and resources to help ensure all patients get tested for HIV early in their pregnancy. All materials can be ordered free of charge by visiting www.cdc.gov/actagainstaids/campaigns/ottl/ .

Due to the diligence and commitment of obstetricians and gynecologists, we have made great strides towards eliminating perinatal HIV transmission. With continued routine prenatal care, universal HIV screening, and timely HIV treatment, together we can achieve this goal!

Sincerely,

/Eugene McCray, MD/

Eugene McCray, MD
Director, Division of HIV/AIDS Prevention
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention
Centers for Disease Control and Prevention

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