# Presentation: 751284

## Perinatal HIV Screening: Efforts to Monitor Trends and Reduce Transmission in South Carolina

***DataSpeak, April 21, 2004***
**Sara Balcerek & Sarah Cooper, MCH**
**Lynda Kettinger, STD/HIV**
**South Carolina Department of Health and Environmental Control**

## MCH/HIV Collaboration Efforts

- DHEC Health Services philosophy of promoting collaboration and integration
- MCH/HIV: Long history of partnerships in planning and delivering services, e.g. routine prenatal screening, jointly fund staff (social work, training), shared data, Family Support Services, Health Services Operational Plan

## Over 15 years of Partnerships

**1988       -         1994**

**Routine**
**HIV Screening**
**In Prenatal **
**Clinics**

**Co-funded**
**HIV Social **
**Work**
**Consultant**

**Co-Wrote**
**1****st**** Awarded**
**RW Title IV**
**Project**

**1995       -      1999**

**2000      -       2004**

**Co-funded**
**Preventive **
**Health **
**Training**

**Legislative**
**Testing Bills/**
**SCMA-MICH**

**Provider**
**Screening**
**Survey**

**Hospital **
**L&D**
**Screening**
**Survey**

**OB**
**Taskforce**
**Updates**

**CDC**
**Perinatal **
**Prevention**
**Funding**

**Prenatal**
**Screening**
**Recom-mendations**

## MCH – HIV/AIDS Collaboration Efforts to Assess Prenatal Screening in South Carolina

- 1998 -   Prenatal Provider Survey to Assess                                                                                        Prenatal Screening Rates
- 2000 -   Hospital Labor and Delivery Survey to Assess Rapid Testing
- 1998 & 2000 – PRAMS Survey Data
- 2004 -   CDC Hospital Chart Review Assessment

## HIV Prenatal Screening Assessments

**1997 Provider Survey**
- Mail survey
- 310/624 licensed MD’s    responded (49%)
- 97% reported routinely screening pregnant women
- 21% screened without     patient consent

-    **2000 Hospital Survey**
- Partnered with Regional Perinatal Systems staff
- 46 of 49 Hospitals responded (94%)
- 54% did NOT provide rapid HIV screening

## Percent of SC Women Receiving a Blood Test for HIV During Pregnancy or Delivery, 2000 (PRAMS)

- Yes		81.3%
- No		18.7%

- _If no, most common barriers:_
- Wasn’t offered the test		36%
- Didn’t think I was at risk		27%
- Previously tested			19%
- Other					16%

## MCH – HIV/AIDS Collaboration Efforts to Reach Perinatal Providers in South Carolina

- Routine Updates to OB Task Force
- Provider Training (Ryan White/CDC)
- Epi Notes Publication
- Prenatal Screening Recommendations  - DHEC  Website: www.scdhec.net/hs/diseasecont/disease.htm

## SC Perinatally HIV-Exposed Births by Year of Birth Compared to Survey of Childbearing Women

**SC Perinatally HIV-Exposed Births ****by Year of Birth Compared to ****Survey of Childbearing Women**

**An estimated 100 infants are born annually exposed to HIV**

**Notes:**
The SCBW is the SC Childbearing Women HIV serosurvey conducted on live births from all hospitals in SC in the early 1990’s through 1999.  The slide shows the estimated “gap” of HIV infected women known to SC DHEC HIV surveillance that delivered infants exposed to HIV.  As routine screening of pregnant women has increased statewide, there is no longer the  need for conducting the seroprevalence survey.  

## Time of SC Mothers’ HIV Diagnosis, Percent of Total Births 1994 verses 2002

| Time of HIV Diagnosis | 1994 | 2002 |
| --- | --- | --- |
| Before Pregnancy | 44% | 65% |
| During Pregnancy | 33% | 35% |
| At Delivery | 3% | 0% |
| After Pregnancy | 15% | 0% |
| Refused/Unknown | 5% | 0% |

## Received / Prescribed (3 Arms) AZT During Pregnancy, Labor & Delivery, & Neonatal Periodby Birth Year for 1994-2002

- Data from South Carolina HIV/AIDS Surveillance, data provisional

## Number of SC Perinatally Acquired HIV/AIDS Cases by Birth Cohort Year, 1994-2002

- Source: provisional SC DHEC HIV/AIDS Program Surveillance Data

**Pediatric cases dropped from 14 to 3 cases**