| Abstract: | Two years after the breakthrough study, ACTG 076, showed that zidovudine (AZT) therapy can dramatically reduce HIV transmission from mother to child, the U.S. Public Health Service has issued guidelines for health care workers that stress non-directive, volunteer counseling and testing for all pregnant women. Highlights of the recommendations include: pre-test counseling following guidelines for HIV counseling; consent for testing obtained according to prevailing legal requirements; and post-test counseling which includes an explanation of the clinical implications of testing positive and the need for early intervention services. In addition, recommendations for HIV-infected pregnant women include assessing patients in the same way as other HIV-infected persons as to their need for antiretroviral therapy, antimicrobial prophylaxis, and other treatment; advisement against breast-feeding; counseling about possible negative effects of HIV infection; and encouragement to obtain HIV testing for any children born after infection. The Centers for Disease Control and Prevention (CDC) estimates that 7,000 HIV-infected women in the United States bear children each year. Up to one-third of these children may become infected after birth. Transmission from mother to child can occur during labor, delivery, and after birth through breast-feeding. Two known factors that decrease the chances of transmission are cesarean-section delivery and administration of AZT therapy during pregnancy. |
