Factors contributing to delayed diagnosis of HIV-infected women and their children in south Texas.
Preliminary results from a previous study at a family human immunodeficiency virus (HIV) clinic in South Texas indicated that HIV-positive (HIV+) children from small communities were usually infected and often symptomatic at the time of referral. The current study evaluated rates of vertical transmission and factors that contributed to delayed diagnosis of HIV for 82 children born to HIV-infected women in South Texas. Children from smaller metropolitan statistical areas (MSAs) were infected more often (70.4% vs. 33.3%), identified later (average 9.7 vs. 3.2 months) and were less often known to be HIV+ at birth (51.4% vs. 64.4%), than those from the largest MSA. In addition, children whose mothers were infected sexually were infected more often (52.8% vs. 32.0%), tested later (average 7.6 vs. 1.6 months), and were less often known to be HIV+ at birth (46.8% vs. 85.2%), than those children whose mothers were injecting drug users (IDU). Children followed from birth were infected less often (34.3%) than those identified later (65.5%). In South Texas, children born to HIV+ mothers were at higher risk for missed or delayed diagnosis if they were from small MSAs and had mothers who were infected sexually. Early diagnosis of HIV+ women and children is increasingly important because of advances in treatment of HIV and prevention of vertical transmission of HIV.