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February 2004 Issue

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UC Examines Optimal Strategy for Pregnant Women at Risk for HIV

Published February 2004

For women who come to a medical facility in labor and without prenatal care, testing and treating with anti-HIV drugs would prevent HIV infections and save costs in the long-term. These findings are a result of research done at the UC Medical Center, and appear in the January/February 2004 issue ofMedical Decision Making.

The study was led by Joseph Mrus, MD, MSc, assistant professor, and Joel Tsevat, MD, MPH, professor and director of the Section of Outcomes Research in the Department of Internal Medicine at UC. In the report, the UC researchers noted that under currently accepted guidelines, rapid HIV testing and treatment is recommended for women who come to a medical facility in labor but without prenatal care.

“Although rapid HIV testing and treatment is recommended, the optimal drug regimen to use is controversial, and the feasibility of testing at sites where there are few women without prenatal care and/or the rate of HIV infection is low is unclear,” said Dr. Mrus.

Using simulation modeling, results of this study showed that for women in labor without prenatal care, testing for HIV and administering drug therapy to the women who test positive is cost-effective. Treating the women for HIV during labor, without HIV testing first, was also cost effective in preventing transmission of HIV from mother to child and may be a reasonable strategy at sites where rapid HIV testing is not possible or practical. Additionally, the UC researchers concluded that using two or three anti-HIV drug regimens, although more expensive, is likely to be more cost effective in the long-term than a standard single drug regimen.

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