Success in implementing Public Health Service guidelines to reduce perinatal transmission of HIV--Louisiana, Michigan, New Jersey, and South Carolina, 1993, 1995, and 1996.

In 1994, the Public Health Service (PHS) published guidelines for zidovudine (ZDV) use to reduce perinatal transmission of human immunodeficiency virus (HIV) (1), and in 1995 published guidelines for HIV counseling and voluntary testing of pregnant women (2). To directly assess the implementation of these guidelines and to identify barriers to the continued reduction of perinatal transmission, four states that conduct surveillance for HIV/acquired immunodeficiency syndrome (AIDS) (Louisiana, Michigan, New Jersey, and South Carolina) enhanced routine surveillance activities to conduct a population-based evaluation. This report summarizes the preliminary results of the evaluation, which identified 1) increases from 1993 to 1996 in the proportion of pregnant HIV-infected women in whom HIV infection was diagnosed before the birth of their child, 2) increases in the proportion of women offered ZDV and 3) lack of prenatal care as a critical obstacle to fully implementing the guidelines.