Date: Mon, 22 May 1995 09:18:14 +0500
From: ghmcleaf{CONTRACTOR/ASPEN/ghmcleaf}%NAC-GATEWAY.ASPEN@ace.aspensys.com
Subject: CDC Press Release, May 15, 1995


P R E S S    R E L E A S E
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CENTERS FOR DISEASE CONTROL AND PREVENTION
National Center for Prevention Services


CDC Focuses on Preventing Perinatal Transmission


May 15, 1995 -- Helene Gayle, M.D., Associate Director of the
Centers for Disease Control and Prevention (CDC) Washington
Office and Acting Director of CDC's National Center for
Prevention Services, announced the agency's goals for preventing
mother-to-child, or perinatal, HIV transmission.  Dr. Gayle was
one of several witnesses testifying before the House Committee on
Energy and Commerce's Subcommittee on Health and the Environment
hearing on HIV testing for pregnant women and newborns held May
11, 1995.

In February 1995, the CDC released draft "PHS Guidelines for HIV
Counseling and Voluntary Testing for Pregnant Women". These
guidelines, which will be published in June, were developed
following a National Institutes of Health study (ACTG 076) that
demonstrated that HIV-infected pregnant women could reduce
transmission to their infants by as much as two-thirds by taking
zidovudine (AZT) during pregnancy and delivery.

To give babies the best chance for a healthy life, free of the
AIDS virus, HIV-infected women must be reached as early in
pregnancy as possible.  In order to achieve that, the guidelines
recommend routine HIV counseling and voluntary testing for all
pregnant women.  This strategy has already proven to be effective
in several communities nationwide and is the most effective way
to identify women and children in need of care.  Unlike mandatory
testing, voluntary testing doesn~t run the risk of driving women
away from prenatal care.  Instead it helps to establish the
relationship of trust that is essential for discussions about
complex medical issues.

As public health and medical professionals prepare to implement
the guidelines, CDC is taking steps to ensure that they are
rapidly adopted and to evaluate their effectiveness.  Within the
next few weeks, CDC will begin a process, assisted by external
expert consultants, to ensure that all pregnant women are offered
HIV counseling and voluntary testing and that they and their
children are entered into a continuum of medical and support
services.  In addition, this planning process will determine the
best mechanisms for evaluating perinatal prevention efforts and
for monitoring the epidemic in women and children.

The future of one of CDC's current monitoring tools, the Survey
of Childbearing Women, will be assessed.  This anonymous survey
involves the "blinded" HIV testing of newborn blood samples and
has been the subject of recent media reports as well as proposed
federal and state legislation.  According to Dr. Gayle, "The
Survey of Childbearing Women has provided critical information
for monitoring the epidemic in women and children.  However, a
lot has changed since that survey was first developed.  With the
tremendous opportunity that we now have to prevent most perinatal
transmission, we must do everything possible to keep our eye on
the goal of preventing HIV infection in children.  I am confident
that the planning process that CDC is beginning will provide us a
strong foundation for determining how best to achieve this goal."

Until this process is completed, State Health Departments have
been asked in a letter from Dr. Phil Lee, Assistant Secretary for
Health, to suspend the Survey of Childbearing Women.

"With these recent advances," added Gayle, "CDC must re-evaluate
how to best combine prevention and surveillance strategies to
meet these important challenges.  We are eager to begin the
planning process and move forward with the task of implementing
and evaluating perinatal prevention efforts."