Overview
Welcome to this issue of Preventing Perinatal HIV Transmission: Field Update. You are receiving this newsletter because you expressed an interest in perinatal HIV prevention in hospitals or have signed up to receive it. This quarterly email newsletter connects its subscribers to news updates, trends, statistics, prevention programs, policy initiatives, tools, and useful practices relating to perinatal HIV prevention in U.S. hospitals. The Health Research and Educational Trust (HRET), with support from the Centers for Disease Control and Prevention (CDC), produces this newsletter as a forum for information dissemination and for communication among and between hospital staff, HIV experts, and researchers.

For more information on HRET's Perinatal HIV Prevention project, please visit our newly updated web site.

If you have comments or suggestions for future issues of this newsletter, please contact Jennifer Reiter at jreiter2@aha.org.

New Online Guide from HRET on ED-based HIV Testing Available
To guide clinicians and administrators through the process of planning, implementing, or expanding emergency department-based HIV testing programs, HRET has developed a free Web-based operational guide. This comprehensive resource—the first of its kind—is based on interviews and site visits with emergency departments (EDs) that have pioneered ED-based HIV testing.

The CDC estimates that as many as 25% of the 1.2 million Americans who are HIV positive are unaware that they are carrying the virus. Early detection of the HIV virus has been shown to reduce risk behaviors, and it can link infected patients to care. CDC now recommends voluntary HIV screening for adult and adolescent patients in all health care settings. ED-based testing can be an effective strategy for screening hard-to-reach populations.

The HIV testing guide outlines different approaches, considerations, and resources for making HIV testing routine in ED care. The guide also includes detailed information on such topics as making the case, costs and funding, measuring progress, legal considerations, training staff, and linkage to care.

For more information and to begin using the guide, visit their Web site.

National Partners Co-Author Article on Preventing Perinatal HIV Transmission
Representatives of the National Organizations’ Collaborative to Eliminate Perinatal HIV in the US recently co-authored an article on the public health success of preventing perinatal HIV transmission in the U.S. The article is titled, “An End to Perinatal HIV: Success in the US Requires Ongoing and Innovative Efforts that Should Expand Globally” and is available in the Journal of Public Health Policy. Francie Margolin, Vice President of Operations and Co-Principal Investigator for HRET’s Preventing Perinatal HIV project that is part of a CDC Cooperative Agreement, is a co-author of the article.

Illinois Bill That Would Remove Written Consent Requirement for HIV Tests Signed Into Law
Governor Rod Blagojevich signed into law Bill 980 which would remove a state requirement that people receiving HIV tests provide written consent prior to receiving the test. The final version of the bill aims to eliminate barriers to testing while increasing penalties for violating patients' privacy or right to consent.

Under the new law, once people consent to be tested for HIV, they will receive pretest information about the virus and how to understand their results. People who test positive for HIV must be informed of their results by medical staff in person, and doctors are required to provide counseling and medical references. Additionally, people are able to decline to be tested for HIV.

To read the full bill, click here.

Nevada Senate Bill 266 on Preventing Perinatal HIV Transmission Signed Into Law
Following up from the May newsletter in which we reported that Nevada Senate Bill 266 had passed the Senate, the bill sponsored by Senator Steven Horsford and Representative David Parks was signed into law by Governor Jim Gibbons on June 13th.

Senate Bill 266 has three primary components. First, the bill requires a health care provider ensure that a woman receives a test for HIV, as part of the routine prenatal care recommended during the first trimester of pregnancy, unless the woman chooses not to be tested. The bill also requires a health care provider to ensure that a pregnant woman receives a test for HIV during her third trimester if she receives health care in a jurisdiction with a high prevalence of HIV or AIDS among women of child-bearing age or in a high-risk clinical setting, or if she reports that she has one or more of the risk factors identified by the CDC, unless the woman chooses not to be tested.

The second component requires a health care provider to ensure that a pregnant woman receives a rapid test for HIV during labor if she has not been tested for HIV earlier during her pregnancy or the results of an earlier test are not available, unless the woman chooses not to be tested. If the result of the rapid test is positive, the health care provider must offer to initiate antiretroviral prophylaxis as soon as possible without waiting for the results of a confirmatory test.

The third primary component of this bill requires a health care provider who attends or assists at the delivery of a child to ensure that a test for HIV is performed on the child if the mother has not been tested for HIV earlier during her pregnancy or the results of an earlier test are not available, unless a parent objects that performance of the test is contrary to the religious beliefs of the parent.

Amendments from the Senate require a health care provider to ensure that before a woman or newborn child receives any test set forth in the bill, the woman or parent of the newborn child receives a pamphlet informing them of their right to refuse the test.

To read the full bill, click here.

2007 Perinatal Hepatitis B and HIV CDC Grantees’ Meeting Materials Available
The materials from the 2007 Perinatal Hepatitis B and HIV Grantees’ Meeting are now available through CDC’s Web site. Presentations include Mother-to Child HIV transmission: A Thing of the Past? by Jess Fogler from NCCC and UCSF, Effectively Implementing Hospital Policy by Elaine Gross and Carolyn Burr from François-Xavier Bagnoud Center, and The Perinatal Expert Panel: A Collaboration for the Successful Reduction of Perinatal HIV Transmission by Rashidah Abdul-Khabeer and Marie Ranselle from Circle of Care.

Please visit the Web site to see all the presentations given at the meeting.

CDC Releases Updated HIV/AIDS Surveillance Numbers
On June 28th, CDC issued a revision of the 2005 HIV/AIDS surveillance report which was originally published in November 2006. The updated report reflects a correction in the analysis of estimated surveillance data. Although the overall number of AIDS cases in 2005 was revised downward as a result of this change, the corrected number of pediatric AIDS cases for 2005 was revised upward, from 58 to 68.

To read the revised report and data, please click here.

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