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Keywords

African American women; Communicable diseases in the fetus; HIV; HIV-positive women; Linkage; Maternal-fetal exchange; MTCT; Perinatal; Race and ethnicity

Abstract

Objectives: African American women, living with HIV, exhibit a higher percentage of giving birth as compared to other race/ethnicity groups. The aim of this study is to understand the apparent black and non-black differences (health disparities) among the HIV Infected Mothers group and examine whether race/ethnicity can explain the high variation in different prenatal and HIV mother-to-child-transmission (MTCT) risk factors.

Methods: Data-Linkage was conducted on all women HIV+ cases, who delivered a child during the time period and reported to the Nevada state HIV with the live birth registries. Demographic and social data, separated into black and Non-black groups, were analyzed using logistic regression techniques on HIV maternal transmission and prenatal risk factors such as smoking, alcohol and drug use, prenatal care and sexual orientation.

Results: From 1990 through 2005, 189 women living with HIV in Nevada gave birth. Of these mothers 58% were black, ten times higher than their population proportion and over seven times the percentage of black women in the HIV negative mother population. The estimated odds ratio of HIV maternal transmission risk factors for women increased significantly within the categories of income ratio, marital status, education and previous births, but remained approximately equal in the category of race/ethnicity. Odds ratios for HIV transmission also decreased significantly for women according to age.

Conclusions: Odds ratios of HIV risk factors occur highly disproportionate for certain demographic variables, but not for the race/ethnicity categories of black and Non-black women. Cross-match between health information systems may trace unresolved research questions.