Clinical Practice: Unite Against HIV/AIDS on December 1, World AIDS Day
Each year, there are 50,000 new HIV infections in the United States. Approximately 20 percent of these infections occur in women, and women of color are disproportionately affected.
ACOG continues to be actively involved in education, prevention, and treatment of HIV, offering multiple resources for providers. ACOG recently partnered with the Rutgers Francois-Xavier Bagnoud Center on a pre-exposure prophylaxis (PrEP) in ob-gyn practice webinar. The webinar is archived online and available for you to view at any time. Additional resources on HIV/AIDS are easily accessible on the ACOG website.
Prevention and Screening
Pre-exposure prophylaxis (PrEP), in the form of a single pill of a fixed dose of tenofovir and emtricitabine, is available to prevent HIV transmission. Women at the highest risk of acquiring HIV infection should be considered as candidates for PrEP. With daily adherence, PrEP is approximately 90 percent effective in preventing HIV transmission.
Committee Opinion 595, “Pre-exposure Prophylaxis for the Prevention of Human Immunodeficiency Virus,” reviews the available data and provides guidance on PrEP.
All women should be screened for HIV at least once between the ages of 13-64. Most cases of HIV infection in women are diagnosed in the reproductive years, and an ob-gyn is often the first health professional to provide care for an infected woman. See Committee Opinion 596, “Routine Human Immunodeficiency Virus Screening,” for more information on screening your patients.
Pregnant Patients with HIV
The reduction in mother-to-child HIV transmission is a public health success story. Early identification and treatment of HIV infection in pregnant women not only improves the health of the mother, but is the best way to prevent neonatal disease.
The use of antiretroviral medications given to women with HIV during pregnancy and labor, and to their newborns in the first hours after birth, has been shown to reduce the rate of mother-to-child HIV transmission from 25 percent to less than 1 percent. Without treatment, approximately 1 in 4 exposed babies will be infected.
Obstetricians continue to be at the forefront of the effort to eliminate mother-to-child HIV transmission. Information on prenatal and perinatal HIV testing is available in Committee Opinion 635, “Prenatal and Perinatal Human Immunodeficiency Virus Testing: Expanded Recommendations.” Also, Practice Bulletin 167, “Gynecologic Care for Women and Adolescents with Human Immunodeficiency Virus” discusses recommended gynecologic treatment for HIV-positive women and adolescents.
On World AIDS Day, take the opportunity to unite against HIV/AIDS, provide support for people living with HIV/AIDS, and remember those who have died from AIDS.
For more information, visit ACOG's HIV webpage, and see resources available for pregnant women on the Women and HIV website.