With the advances in medical science, perinatal HIV-1 transmission rates in the United States have decreased strikingly due to an amalgamation of suitable measures taken; encompassing improved voluntary counseling and HIV-1 testing (VCT) for pregnant women, prevalent use of antiretroviral prophylaxis or combination of antiretroviral therapy, avoidance of breastfeeding, and elective cesarean delivery (Shetty, 2005). In some cases the preventive measures are not seriously taken and these missed opportunities are responsible for 300 to 400 HIV- 1 infected infants, born annually. It is the sole responsibility of the pediatrician to prevent perinatal transmission of HIV-1 by finding out newborns born to infected mothers. These mothers are not tested during pregnancy. Pediatrician must administer antiretroviral prophylaxis, and ensure follow-up to verify or eliminate the diagnosis of HIV-1 infection in early infancy (Shetty, 2005). Estimates of the number of children infected with HIV in the United States range from 10,000 to 20,000. Nearly all (90%) new HIV infections in children result from perinatal transmission. The overall incidence of perinatally acquired AIDS cases declined by 67% from 1992 through 1997 (Priority: HIV and AIDS). It is manifested that number of perinatally acquired cases increased each year between 1984 and 1992, the current results reveal the decrease in the statistics not only in terms of number of new cases but also a reversal of the previous cases (Priority: HIV and AIDS). Decline in perinatal transmission are attributed largely to the combined effect of both increased counseling and testing for HIV infection prenatally and the use of zidovudine (ZDV) therapy during pregnancy among HIV-infected women (Lindegren, 1999). The AIDS Clinical Trials Group (ACTG) 076 trial demonstrated that ZDV therapy reduced perinatal transmission from 25.5% to 8.3%. it is also manifested that Standard therapy defined by the US Public Health Service (USPHS) emphasize upon oral administration of ZDV to the mother in the prenatal period, intravenous administration of ZDV during the intrapartum period, and oral administration of ZDV to the newborn (Mofenson, 1999). More effective counseling and testing prenatally makes it possible for a greater number of women and infants to benefit from antiretroviral therapy. It is observed that, some women still do not receive antiretroviral therapy during the antepartum period as recommended, it is therefore essential that the treatment schedule of - before, during, and after delivery of the ACTG protocol must be strictly followed to reduce the perinatal HIV infection, a noteworthy declines in perinatal transmission were examined since 1995 due to the speedy integration of this regimen into clinical practice (Mofenson, 1999).
Healthy People 2010 Baselines and Targets for HIV/AIDS has included objective no. 13.17 for reducing new AIDS cases of perinatally acquired HIV infection to reduce the rate of infant mortality (Priority: HIV and AIDS). The table in the appendix indicates trends in AIDS and HIV cases in newborns for the years 1999-2003 in Chautauqua County. The rate is diminishing, indicates that over the period the number of newborns with HIV has reduced (Priority: HIV and AIDS).
According to the Health People 2010 Initiative, 50% of HIV