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No infants were infected with the AIDS virus by their mothers during or near the time of delivery, according to preliminary records from the state Department of Health and Family Services.
It’s just the third year the state has had no births involving HIV since 1985. The others were 1999 and 2004.
Experts applaud the progress but say a lack of routine testing of pregnant women for HIV is preventing further success.
“We should be at zero births with HIV every year,” said Dr. Peter Havens, medical director of the Wisconsin HIV Primary Care Support Network, based at the Children’s Hospital of Wisconsin in Milwaukee.
In 1994, doctors discovered that drug treatments can greatly reduce HIV transmission from pregnant women to their babies. If four steps are followed, the risk of passing along the virus drops from about 25 percent to less than 2 percent, Havens said.
The steps: infected women take a three-drug “cocktail” regularly after the first trimester of pregnancy; they get one drug intravenously during labor until delivery; the baby gets a drug for six weeks after birth; and there is no breastfeeding.
From 1994 to 2005, 22 babies born to HIV-positive mothers in Wisconsin acquired the virus during or near the time of delivery, said Stephanie Marquis, spokeswoman for the state health department.
That’s a considerable improvement from the 31 babies infected from 1985 to 1994.
But the progress could be even greater if all pregnant women were tested for HIV, Havens and others say. Some women don’t know they are infected. If their doctors also don’t know, they can’t recommend the steps to prevent transmission.
The tests, which aren’t mandatory, are not performed as routinely during prenatal care as those for syphilis, gonorrhea and other sexually-transmitted diseases that can be passed to babies, said Dr. Gregory DeMuri, a pediatric infectious disease specialist at UW Hospital.
About 68 percent of pregnant women in Wisconsin are tested for HIV, a study last year by the state health department found. Rates vary from 85 percent in Milwaukee County, where HIV is more prevalent and testing efforts have been stronger, to about 60 percent in Dane County and rural parts of the state.
“The challenge is to increase our screening rate because we don’t know who we’re missing,” DeMuri said.
A few years ago, he said, a pregnant woman who hadn’t received prenatal care tested HIV-positive two weeks before she had a baby in Madison.
Doctors gave drugs to her before the delivery and to the baby afterward, but the infant was infected because it was too late for the treatments to work, DeMuri said. The baby has become a relatively healthy toddler, but she will have to take powerful drugs for the rest of her life, he said.
“It really speaks to the importance of prenatal care and testing,” he said.
The state health department says Wisconsin law requires written consent for HIV testing. That means the state can’t do what the U.S. Centers for Disease Control and Prevention recommends: test pregnant women unless they say no.
Instead, doctors are urged to ask women to be tested. But some doctors don’t.
The tests are covered by insurance, so cost isn’t an issue, Havens said. But some doctors feel uncomfortable asking patients to take a test for a disease that continues to carry a stigma, Havens and DeMuri said.
Others incorrectly think their patients aren’t at risk, DeMuri said.
“Every pregnant woman has at least one risk factor for HIV infection — that is, unprotected intercourse at least once,” he said.
Even without changing state law, Wisconsin could increase HIV testing of pregnant women if the state health department required hospitals to make sure a test result is in a woman’s medical chart before delivery, as Illinois does, Havens said.
Wisconsin health officials are considering such a change, he said.
Madison’s Meriter Hospital and St. Mary’s Hospital don’t require a test result, spokeswomen for the hospitals said. The hospitals rely on doctors to ask women about the test during prenatal care, they said.
Nationally, the estimated number of babies born with HIV has dropped from a peak of 1,650 in 1991 to about 240 each year today, said Jennifer Ruth, a spokeswoman for the CDC.
