Objective: To describe the pattern of perinatal exposure to HIV in Australia from 1 January 1982 to 31 December 1994.
Design: National surveillance for perinatal exposure to HIV.
Participants and setting: Women with diagnosed HIV infection in Australia whose children were exposed to HIV perinatally.
Outcome measures: Number of reported cases of women with diagnosed HIV infection who have had perinatally HIV-exposed children.
Results: By 31 December 1994, 91 women diagnosed with HIV infection had had 111 perinatally exposed children. While the rate of perinatal exposure to HIV was highest in the Australian Capital Territory and New South Wales, the rate was substantially lower than the rate of diagnoses of HIV and AIDS in women of child-bearing age. Before 1989, only 15% (6/39) of women knew of their HIV infection before the birth of their first perinatally exposed child: by 1989-1994, this had increased to 64% (32/52; P < 0.0005). Overall, exposure to HIV was attributed to heterosexual contact only, injecting drug use or receipt of blood or tissue by 48%, 31% and 18% of women, respectively. Source of HIV exposure changed from a history of receipt of blood in 78% of women whose first exposed child was born in 1982-1985 to heterosexual contact only in 61% of women whose first exposed child was born in 1992-1994. 38 children acquired HIV infection perinatally. The HIV transmission rate to children born to women diagnosed with HIV infection before delivery was 21.6% (11/51).
Conclusions: Perinatal exposure to HIV in Australia remains rare. While the proportion of women diagnosed with HIV infection after delivery decreased, a substantial number continued to be diagnosed after delivery, precluding use of current interventions that can reduce the risk of perinatal transmission. It may be appropriate to review the application of HIV testing during pregnancy in Australia.