Failure to Identify Human Immunodeficiency Virus-Seropositive Newborns: Epidemiology and Enrollment Patterns in a Predominantly White, Nonurban Setting

摘要: Objective. To describe the epidemiology of newborn seroprevalence for human immunodeficiency virus (HIV) in a predominantly white, nonurban population, and to determine factors associated with enrollment at regional pediatric acquired syndrome (AIDS) center serving that population. Design. Retrospective case series children enrolled AIDS during 6-year period comparison universal blind screening data collected by state New York same time interval. Setting. The Pediatric Center State University York-Health Science Syracuse, which serves as only source HIV-related care 16-county region upstate totaling 1.8 million Results. One hundred thirty-nine HIV-seropositive infants were born study period; complete available 138. Sixty-five (47%) these white. Thirty-nine (28%) 138 had been within first 90 days life. An additional 22 (16%) older than remaining 77 (56%) have never seen are presumed be unidentified. County rates varied from 0% 100% correlated percent nonwhite births (r = .58; 95% confidence interval, 0.04-0.86). Children outlying counties greater risk nonenrollment Onondaga (site Center) (adjusted relative risk, 1.38; 1.05-1.85). White residing outside greatest nonenrollment; 50 seropositive white County, 7(14%) Conclusions. Local demographic can skew racial distribution dramatically compared national experience. race residence away medical each constituted Center. HIV this rural coupled physician practices, probably contributed low identification rates. As epidemic spreads into similar populations elsewhere, infection pregnant women or is likely become progressively harder detect, unless adopted.