Women and Children: The Perinatal HIV Program

HIV/AIDS in women and their children

HIV/AIDS in women and their children
The number of women with HIV and AIDS is steadily rising: according to the World Health Organization, approximately 45 percent of the 39.5 million adults living with HIV/AIDS worldwide are women. Nationally, from 1985 to 2005 the proportion of reported U.S. AIDS cases occurring among women increased from 8 percent to 26 percent. HIV infection is now the third leading cause of death among women ages 25 to 44 and the leading cause of death among black women in this age group. In Florida, women accounted for 22 percent of newly reported AIDS cases in 1994 and 32 percent of AIDS cases in 2006. Women now account for 35 percent of cumulative reported HIV cases and 25 percent of cumulative reported AIDS cases. Florida's minority communities are disproportionately impacted by HIV/AIDS. Of the 24,789 female HIV/AIDS cases reported through 2005, 66 percent were among blacks, 18 percent were among whites and 15 percent were among Hispanics. The vast majority of HIV-infected women diagnosed in 2006, contracted the virus through heterosexual contact (86 percent).

An HIV-infected pregnant woman can transmit the virus to her infant during pregnancy, at labor and delivery, or through breastfeeding. Medical treatment is available that can reduce the risk of perinatal (mother-to-child) HIV transmission from a high of approximately 30 percent, to less than 2 percent. The use of multi-drug therapy is known to be safe and effective for both the mother and infant. Consequently, it is important for all pregnant women to get prenatal care early in their pregnancy and receive an HIV test at the beginning and the end of their pregnancy.

Florida has made great strides in reducing pediatric HIV/AIDS (cases reported in children less than 13 years of age). As the vast majority of pediatric HIV/AIDS cases (95 percent) are perinatally acquired, the Department of Health has focused on educating women and health care providers on the importance of HIV testing for pregnant women and the availability of treatment to prevent perinatal transmission. The effectiveness of this program is evident in the current data: the number of newly diagnosed HIV and AIDS cases in infants has declined 94 percent since 1992, and Florida’s perinatal HIV transmission rate (the number of HIV-infected women that deliver an infected infant each year) is now below 2 percent.

In 2005, the Florida legislature revised the statute regarding HIV testing of pregnant women (s.384.31, F.S.). The law eliminated the requirement for a separate HIV consent and the testing was broadened to include other STDs. Pregnant women must now be notified that they will be tested for HIV, syphilis, Chlamydia, gonorrhea, and hepatitis B (at the initial visit and 28-32 weeks) and that they have the right to refuse any or all tests. Women who opt out of testing must sign a statement of objection. Counseling is encouraged for women who refuse testing. Women who present at labor and delivery with an undocumented HIV/STD status are tested unless they refuse. Florida Administrative Rule 64D-3.042 also states that emergency departments may fulfill the testing requirements stated above by referring, in writing, pregnant women who have not received prenatal care (12+ weeks gestation) to the local county health department for testing. For further information on Florida's perinatal HIV prevention program, please contact Nita Harrelle or Marlene LaLota at the Florida Department of Health, Bureau of HIV/AIDS.Phone: 850-245-4424

Baby Rxpress Program

Statement of Objection to HIV Testing for Pregnant Women (DH3161) (

Creole Testing Form DH3161

Spanish Testing Form DH3161

The Targeted Outreach for Pregnant Women Act Program (TOPWA)
Outreach program to at-risk pregnant women not receiving adequate prenatal care and services.

Perinatal Social Marketing Campaign
Link to the Bureau of HIV/AIDS We Make The Change website

USF Center for HIV Education and Research Perinatal Program
Provider training on HIV testing for pregnant women and the care/treatment of the HIV-infected pregnant woman.

Ryan White Part 4
Part 4 program Provider list

University of Florida Reports
A survey of Florida obstetric providers related to HIV and pregnancy, and a study of Florida hospital policies and procedures related to the HIV testing of pregnant women and the care and treatment of HIV-infected pregnant women.

CDC Revised HIV Testing of Pregnant Women Guidelines
Link to the CDC recommendations for HIV counseling and testing of pregnant women.  

François-Xavier Bagnoud Center's NPHRC Web Site
Link to the National Pediatric Family HIV Resource Center for information on the latest perinatal HIV prevention and treatment resources.

HIV/AIDS Fact Sheets
Fact sheets on HIV/AIDS Among Women, Pediatric HIV/AIDS, and the impact of HIV/AIDS on other Florida populations.

HIV/AIDS Trends and Statistics
Adobe Acrobat and Power Point slide sets on HIV/AIDS Among Women, Pediatric HIV/AIDS Surveillance Data, and HIV/AIDS prevalence data on other Florida populations.

Other Resources
Links to other health department programs and state organizations working with women and children.

Florida HIV/AIDS Hotline at 1-800-FLA-AIDS
1-880-352-2437
1-888-503-7118 (TDY)
1-800-545-SIDA (Spanish)
1-800-AIDS-101 (Creole)