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Illinois hospitals are not ready to implement intrapartum strategies to eradicate pediatric HIV infection

A combined regimen of zidovudine (AZT) provided to HIV-infected mothers during pregnancy and labor and to exposed newborns for 6 weeks postdelivery can reduce perinatal HIV infection by 67 percent. When maternal HIV status is known by U.S. perinatal care providers and appropriate actions are taken, the risk of HIV transmission from mother to child can be reduced to less than 2 percent. Yet, despite the 2003 passage of legislation in Illinois to increase perinatal HIV testing and reduce transmission, Illinois birth hospitals are not ready to implement the intrapartum interventions needed to eradicate pediatric HIV infection, concludes a new study.

A team of Illinois researchers surveyed nurse managers of all 137 Illinois birthing hospitals about current labor and delivery practices for testing, identification, and documentation of maternal HIV status, and AZT availability in March 2004. This was 6 months after passage of the Illinois Perinatal HIV Prevention Act and prior to Statewide perinatal rapid HIV testing in 2005.

Overall, only 17 hospitals (12.4 percent) met 5 requirements for overall readiness to prevent perinatal HIV transmission. Another 16 hospitals (11.6 percent) met a minimal level of readiness, that is, they documented prenatal HIV status and had AZT available. However, the majority of hospitals (76 percent) did not meet the minimal definition of readiness to prevent perinatal HIV transmission, and over one-third did not have AZT available.

Illinois hospital patterns are likely similar to current hospital practices in other States, note the researchers. Their study was supported by the Agency for Healthcare Research and Quality (T32 HS00078).

See "Ready or not—intrapartum prevention of perinatal HIV transmission in Illinois," by Ann E. Bryant Borders, Rebecca L. Eary, Yolanda Olszewski, and others, in the September 2007 Maternal and Child Health Journal 11, pp. 485-493.

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