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Available and timely access to AZT for HIV-infected mothers giving birth needs to be improved in Illinois birthing hospitals

HIV-infected mothers should be given the antiviral drug AZT (zidovudine), which can reduce mother-to-child HIV transmission up to 67 percent even when administered at labor and delivery. However, a study of all 137 Illinois birth hospital pharmacies in 2005 found that only 43.1 percent reported having AZT available in syrup or intravenous form. Also, only 37.2 percent could make AZT available on labor and delivery floors within 30 minutes during off hours (late at night or on weekends).

In addition, protocols for treating HIV-positive women in labor and HIV-exposed newborns were available in only 37.2 percent of pharmacies. Yet 72.4 percent of hospital pharmacies had protocols for antiretroviral therapy to treat hospital workers accidentally exposed to HIV on the job. Pharmacies at major academic hospitals and those serving mostly white patients were more likely to have AZT available. Also, timely provision of AZT was more likely to occur in urban, major academic hospitals serving a predominantly white population.

Timing of AZT is critical, since HIV-exposed infants need to be protected during a critical window of time. States that initiate perinatal HIV reduction programs need to address AZT availability in hospital pharmacies to ensure complete and timely implementation of their protocols, suggest the researchers. Their study was supported in part by the Agency for Healthcare Research and Quality (T32 HS00078).

See "AZT availability in Illinois birth hospitals: Is the perinatal HIV prevention safety net in place?" by Rebecca L. Eary, Ann E. Bryant Borders, M.P.H., Arden Handler, Dr.P.H., and others, in the July 2007 Maternal and Child Health Journal 11, pp. 313-318.

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