ZIDOVUDINE (ZDV) TREATMENT DURING PREGNANCY IN AN URBAN POPULATION. • 1003

Objective: To study the application of the ACTG 076 trial in an urban population in Houston. Methods: The maternal medical records of infants born between 3/1/94 and 10/31/95 who were referred to the pediatric human immunodeficiency (HIV) service were reviewed to determine prenatal ZDV treatment. Infection with HIV in infants was documented by both a positive polymerase chain reaction and a positive HIV culture on separate specimens.Results: One hundred and four infants were born to 103 HIV infected women between 3/1/94 and 10/31/95. Fifty-one (50%) mothers took prenatal ZDV, 8 (8%) had intrapartum ZDV only, and 44 (43%) mothers did not take ZDV. Eight(18%) refused ZDV, 16 (36%) had no prenatal care (PNC) and maternal HIV status was determined at birth, 11 (25%) had no PNC but were known to be HIV infected, 3 (7%) were not offered ZDV despite being HIV infected and having PNC, 3 (7%) had PNC but were not identified as infected until the birth, 2(5%) women had PNC but their HIV status was determined months after giving birth,and ZDV was contraindicated in 1 (2%)mother. Twelve (12%) infants were HIV infected, 2 (4%) were born to ZDV treated mothers and 10 (23%) were born to untreated mothers. Conclusions: Failure to access prenatal care was the most important impediment to prenatal treatment with ZDV. Prenatal ZDV treatment is as effective in preventing congenital HIV infection in general practice as it was in research setting.