Brief Report: Estimated Incidence of Perinatally Acquired HIV Infection in the United States, 1978-2013

Abstract

Background: An incidence of perinatally acquired HIV infection less than 1:100,000 live births is one of the Centers for Disease Control and Prevention (CDC) goals of the United States. Such an estimate has only been possible in recent years because regular nationwide data were lacking.

Method: Using previously published CDC estimates of the number of infants born with HIV infection in the United States (interpolating for years for which there was no published estimate), and census data on the annual number of live-born infants, estimated incidence was calculated for 1978-2013. Exact 95% confidence intervals (CIs) were calculated using the Poisson distribution.

Results: Estimated incidence of perinatally acquired HIV infection peaked at 43.1 (95% CI: 41.1 to 45.1) in 1992 and declined rapidly after the use of zidovudine prophylaxis was recommended in 1994. In 2013, estimated incidence of perinatally acquired HIV infection in the United States was 1.8 (95% CI: 1.4 to 2.2), a 96% decline since the peak.

Conclusion: Estimated incidence of perinatally acquired HIV infection in the United States in 2013 was 1.8/100,000 live births.

FIGURE 1.

Estimated incidence of perinatal HIV infection per 100,000 live births, United States 1978–2013. The estimated incidence of perinatal HIV infections per 100,000 live births (points) with a smoothed curve (solid line) and 95% confidence bands (dashed lines). The timing of important advances in recommendations for prevention of maternal-to-child transmission of HIV is noted on the figure. The arrows indicate the year in which the interventions (eg, “Zidovudine prophylaxis”) occurred.