Journal of the American Medical Association (08/11/99) Vol.
In an editorial, Dr. Lynne M. Mofenson discusses the potential
for eliminating perinatal HIV in the United States. Dr.
Mofenson, of the National Institute of Child Health and Human
Development at the National Institutes of Health, points out
that although antiretroviral regimens and elective cesarean
births present good strategies for eliminating perinatal HIV,
some problems must still be addressed. Effective programs
must be developed to prevent HIV infection and unintended
pregnancies in child-bearing age women, particularly among
adolescent minorities. In addition, increased efforts must be
made to provide as many women as possible with adequate
prenatal care, and clinicians should include HIV testing as a
part of the standard prenatal tests conducted. The author
notes that "innovative strategies are needed to assess the
feasibility of rapid HIV testing during labor or in the
immediate postpartum period to identify HIV infection in women
who present in labor and have unknown HIV status or have not
received prenatal care." Also, Mofenson asserts that new
surveillance strategies are needed to derive more accurate
data regarding any possible short- or long-term effects of in
utero or neonatal antiretroviral drug exposure.