Transmission of HIV-1 infections from mothers to infants in Haiti: impact on childhood mortality and malnutrition

Article Abstract:

There is comparative little in the medical literature dealing with the rate of transmission of human immunodeficiency virus from mother to child either during pregnancy or during the first year of life. The present study follows the development and infection rates of infants of 4,588 Haitian mothers, of whom 443 (9.7) were found to be infected with the HIV virus, which causes AIDS. The mothers were drawn form a small area of Haiti where the annual yearly income is less than $120 per year, there is a 50 percent unemployment level, there is a 20 percent literacy rate among women, yet nearly 80 percent of pregnant women seek prenatal medical care. The rate of HIV infection in this population has been slowly increasing, from 8.8 percent in 1986 to a level of 10.2 percent in 1988. These mothers do not use intravenous drugs or cocaine, and are a good population to use for examining the rate of transmission of infection to children because the demographic picture is not clouded by drug use. The mothers were all examined during the course of the their pregnancy for the presence of HIV infection. Presence or absence of HIV antibodies in the infant was determined at birth and the children were retested approximately every three months. During the first year of life, babies born to HIV-positive women who were not themselves infected with HIV gradually lost maternal HIV antibodies and became seronegative. No children who were seropositive at one year later became seronegative, meaning they were infected. The estimated rate of mother-to-infant transmission of HIV in these breast fed infants was approximately 25 percent. This compares with figures obtained within for non-nursing Haitian mothers who reside in the United States. This appears to support the advisory by the World Health Organization that mothers continue to breast feed without regard to their HIV status. Presence of HIV antibodies in children of infected mothers was found to correlate with decreased birth weight, increased rate of infant death (23.4 percent of HIV-positive mother's babies were dead at one year vs. 10.8 percent of the babies of seronegative mothers), and a malnourished state as evidenced by body weight. The impact of HIV on this Haitian community has been to reverse the recent trend toward lower childhood mortality. (Consumer Summary produced by Reliance Medical Information, Inc.)

Patient outcomes, Mortality, Measurement, Demographic aspects, Disease transmission, AIDS (Disease) in children, Pediatric AIDS (Disease), HIV antibodies, HIV seroprevalence

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HIV-1 in Haitian women 1982-1988

Article Abstract:

The prevalence of human immunodeficiency virus-1 (HIV-1) infection was investigated in 4,474 women living in a Haitian urban slum. The women were all pregnant patients of the local health care clinic. The overall prevalence of HIV infection in 1988 among this population was found to be 10.3 percent. This is up from 9.9 percent in 1987 and 8.9 percent in 1986. Married women were significantly less likely to be HIV-positive; being 20 to 29 years old, and having more than one sexual partner increased the risk of infection with HIV. Testing positive for syphilis was also a high risk factor for HIV infection, which has been observed in other studies. Syphilis correlates with high-risk behavior, and, in addition, there is some suspicion that the syphilitic sore may provide an easy portal of entry into the body for the AIDS virus. An unexpected finding of the study is that there was a correlation between smoking and HIV infection. It is not known if this is due to a correlation between smoking and high-risk behaviors, or if smoking has a direct biological effect upon the infection process. The results indicate that the epidemic of HIV-1 infection in Haiti is continuing, and that control efforts may need to focus upon the difficult task of altering heterosexual behavior. (Consumer Summary produced by Reliance Medical Information, Inc.)

Physiological aspects, AIDS virus carriers, HIV carriers

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Sexual behavior, smoking, and HIV-1 infection in Haitian women

Article Abstract:

Haitian women who smoke may have high-risk sexual behavior that may increase their risk of infection with HIV-1. Of 418 Haitian women, 89 were smokers, and 329 were nonsmokers. Forty-nine percent of women who smoked had more than two sex partners during their lifetime, compared to 25% of women who did not smoke. Eleven percent of the smokers were married, compared to 26% of the nonsmokers. None of the women had used intravenous drugs, and smokers did not have more medical or dental procedures or injections than nonsmokers. Thirteen percent of the women who smoked had syphilis, compared to 5% of the women who did not smoke. Eighteen percent of the smokers were infected with HIV-1, compared to 8% of the nonsmokers. Women who smoked more than four cigarettes per day were more likely to be infected with HIV-1 than those who smoked one to four per day. Smoking may cause changes in the vagina, and increase the risk of getting a sexually transmitted disease.

Women, Risk factors, HIV infection, HIV infections, Diseases, Haitians

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