{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T16:06:15Z","timestamp":1777046775320,"version":"3.51.4"},"reference-count":29,"publisher":"American Academy of Pediatrics (AAP)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,7,1]]},"abstract":"<jats:sec>\n                    <jats:title\/>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Advances in preventive strategies have reduced mother-to-child transmission of HIV. The US Department of Health and Human Services (HHS) guidelines on postnatal antiretroviral prophylaxis have evolved to reflect increasingly available evidence. We sought to provide data on postnatal prophylaxis in clinical practice.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>We performed a retrospective study using the MarketScan Multi-State Medicaid Database (2009\u20132021). We identified antiretroviral use among infants and classified them into single-, double-, and triple-drug prophylactic, and therapeutic use. We also characterized new HIV infections in infants in terms of demographics and prophylaxis regimen.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Among 3\u2009147\u2009318 infants included in the study, 2304 received postnatal prophylaxis, with 2123 receiving zidovudine alone. Although zidovudine monotherapy was the only prophylaxis used in 2009, the rate dropped to 71.7% by 2021 as combination prophylaxis became increasingly common (P for trend &amp;lt;.001). Triple-drug prophylaxis became more common than double-drug prophylaxis by 2018. Among 52 infants with HIV infection, 27 (51.9%) were diagnosed between 6\u00a0weeks and 1\u00a0year of life but had not received postnatal prophylaxis, a majority of which were Black (73.8%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>Trends in postnatal HIV prophylaxis in clinical practice closely paralleled evolving HHS recommendations. Although the perinatal HIV infection rate was low, more than half of HIV infections by 1\u00a0year of life occurred in infants who had not received postnatal HIV prophylaxis, suggesting missed maternal infections, most frequently among Black individuals. Heightened awareness is essential for identifying HIV infection as early in pregnancy as possible to enable timely treatment and prevention.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1542\/peds.2025-070746","type":"journal-article","created":{"date-parts":[[2025,6,16]],"date-time":"2025-06-16T20:02:56Z","timestamp":1750104176000},"source":"Crossref","is-referenced-by-count":0,"title":["Postnatal Antiretroviral Prophylaxis and Perinatal HIV Infection in Medicaid-Enrolled Infants"],"prefix":"10.1542","volume":"156","author":[{"given":"Mingyue","family":"Lu","sequence":"first","affiliation":[{"name":"1Gerald R. Ford School of Public Policy, University of Michigan, Ann Arbor, Michigan"},{"name":"2Current affiliation: Division of Health Policy and Administration, School of Public Health, University of Illinois at Chicago, Illinois"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charlotte V.","family":"Hobbs","sequence":"additional","affiliation":[{"name":"3Department of Pediatrics, University of Alabama at Birmingham, Alabama"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kengo","family":"Inagaki","sequence":"additional","affiliation":[{"name":"4Department of Pediatrics, Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan"},{"name":"5Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"417","published-online":{"date-parts":[[2025,6,17]]},"reference":[{"issue":"9903","key":"2026042411065958600_r1","doi-asserted-by":"crossref","first-page":"1525","DOI":"10.1016\/S0140-6736(13)61809-7","article-title":"The end of AIDS: HIV infection as a chronic disease","volume":"382","author":"Deeks","year":"2013","journal-title":"Lancet."},{"issue":"10","key":"2026042411065958600_r2","doi-asserted-by":"crossref","first-page":"657","DOI":"10.1038\/s41579-023-00914-1","article-title":"Prevention, treatment and cure of HIV infection","volume":"21","author":"Landovitz","year":"2023","journal-title":"Nat Rev Microbiol."},{"issue":"1","key":"2026042411065958600_r3","doi-asserted-by":"crossref","first-page":"18593","DOI":"10.7448\/IAS.16.1.18593","article-title":"Understanding the mental health of youth living with perinatal HIV infection: lessons learned and current challenges","volume":"16","author":"Mellins","year":"2013","journal-title":"J Int AIDS Soc."},{"key":"2026042411065958600_r4","article-title":"Prevention of Perinatal HIV Transmission","author":"National Institute of Allergy and Infectious Diseases","year":"2017"},{"issue":"8","key":"2026042411065958600_r5","doi-asserted-by":"crossref","first-page":"721","DOI":"10.1016\/S1701-2163(15)30515-6","article-title":"Guidelines for the care of pregnant women living with HIV and interventions to reduce perinatal transmission: executive summary","volume":"36","author":"Money","year":"2014","journal-title":"J Obstet Gynaecol Can."},{"key":"2026042411065958600_r6","article-title":"Recommendations for the Use of Antiretroviral Drugs During Pregnancy and Interventions to Reduce Perinatal HIV Transmission in the United States","author":"Panel on Treatment of HIV During Pregnancy and Prevention of Perinatal Transmission","year":"2024"},{"key":"2026042411065958600_r7","article-title":"Elimination of mother-to-child transmission","author":"United Nations Children\u2019s Fund (UNICEF)","year":"2024"},{"issue":"21","key":"2026042411065958600_r8","first-page":"592","article-title":"Achievements in public health. Reduction in perinatal transmission of HIV infection--United States, 1985\u20132005","volume":"55","author":"Centers for Disease Control and Prevention (CDC)","year":"2006","journal-title":"MMWR Morb Mortal Wkly Rep."},{"issue":"1","key":"2026042411065958600_r9","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1002\/ijgo.15438","article-title":"Prevented perinatal HIV infections in the era of antiretroviral prophylaxis and treatment, United States, 1994\u20132020","volume":"166","author":"Lampe","year":"2024","journal-title":"Int J Gynaecol Obstet."},{"key":"2026042411065958600_r10","article-title":"Health Coverage by Race and Ethnicity, 2010\u20132022","author":"Hill","year":"2025"},{"key":"2026042411065958600_r11","article-title":"Eligibility Policy","author":"Medicaid.gov"},{"key":"2026042411065958600_r12","article-title":"Health Insurance\/Income","author":"March of Dimes","year":"2020"},{"key":"2026042411065958600_r13","first-page":"1","article-title":"Public Health Service Task Force on the use of zidovudine to reduce perinatal transmission of human immunodeficiency virus","volume-title":"MMWR Recomm Rep.","author":"Recommendations of the U.S","year":"1994"},{"issue":"18","key":"2026042411065958600_r14","doi-asserted-by":"crossref","first-page":"1173","DOI":"10.1056\/NEJM199411033311801","article-title":"Reduction of maternal-infant transmission of human immunodeficiency virus type 1 with zidovudine treatment. Pediatric AIDS Clinical Trials Group Protocol 076 Study Group","volume":"331","author":"Connor","year":"1994","journal-title":"N Engl J Med."},{"issue":"25","key":"2026042411065958600_r15","doi-asserted-by":"crossref","first-page":"2368","DOI":"10.1056\/NEJMoa1108275","article-title":"Three postpartum antiretroviral regimens to prevent intrapartum HIV infection","volume":"366","author":"Nielsen-Saines","year":"2012","journal-title":"N Engl J Med."},{"issue":"1","key":"2026042411065958600_r16","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1089\/apc.2010.0255","article-title":"Postnatal infant HIV prophylaxis: a survey of U.S. practice","volume":"25","author":"McKeegan","year":"2011","journal-title":"AIDS Patient Care STDs."},{"issue":"19","key":"2026042411065958600_r17","doi-asserted-by":"crossref","first-page":"1828","DOI":"10.1056\/NEJMoa1302976","article-title":"Absence of detectable HIV-1 viremia after treatment cessation in an infant","volume":"369","author":"Persaud","year":"2013","journal-title":"N Engl J Med."},{"issue":"8","key":"2026042411065958600_r18","doi-asserted-by":"crossref","first-page":"786","DOI":"10.1056\/NEJMc1413931","article-title":"Viremic relapse after HIV-1 remission in a perinatally infected child","volume":"372","author":"Luzuriaga","year":"2015","journal-title":"N Engl J Med."},{"issue":"3","key":"2026042411065958600_r19","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1093\/cid\/ciaa718","article-title":"Continuous prophylactic antiretrovirals\/antiretroviral therapy since birth reduces seeding and persistence of the viral reservoir in children vertically infected with human immunodeficiency virus","volume":"73","author":"Massanella","year":"2021","journal-title":"Clin Infect Dis."},{"issue":"1","key":"2026042411065958600_r20","doi-asserted-by":"crossref","first-page":"20520","DOI":"10.7448\/IAS.19.1.20520","article-title":"Safety of combination antiretroviral prophylaxis in high-risk HIV-exposed newborns: a retrospective review of the Canadian experience","volume":"19","author":"Kakkar","year":"2016","journal-title":"J Int AIDS Soc."},{"issue":"4","key":"2026042411065958600_r21","doi-asserted-by":"crossref","first-page":"280","DOI":"10.1111\/hiv.12577","article-title":"National audit of perinatal HIV infections in the UK, 2006\u20132013: what lessons can be learnt?","volume":"19","author":"Peters","year":"2018","journal-title":"HIV Med."},{"key":"2026042411065958600_r22","first-page":"130","article-title":"HIV seroconversion during pregnancy and mother-to-child HIV transmission: data from the Enhanced Perinatal Surveillance Project, United States, 2005\u20132010","volume":"15","author":"Singh","year":"2012","journal-title":"J Intern AIDS Soc."},{"key":"2026042411065958600_r23","article-title":"HIV Surveillance Report: Diagnoses of HIV Infection in the United States and Dependent Areas, 2021","author":"Centers for Disease Control and Prevention","year":"2023"},{"issue":"10","key":"2026042411065958600_r24","doi-asserted-by":"crossref","first-page":"e2238161","DOI":"10.1001\/jamanetworkopen.2022.38161","article-title":"Experiences with prenatal care delivery reported by Black patients with low income and by health care workers in the US: a qualitative study","volume":"5","author":"Peahl","year":"2022","journal-title":"JAMA Netw Open."},{"issue":"10","key":"2026042411065958600_r25","doi-asserted-by":"crossref","first-page":"1965","DOI":"10.3201\/eid2910.230421","article-title":"Spike in congenital syphilis, Mississippi, USA, 2016\u20132022","volume":"29","author":"Staneva","year":"2023","journal-title":"Emerg Infect Dis."},{"issue":"46","key":"2026042411065958600_r26","doi-asserted-by":"crossref","first-page":"1269","DOI":"10.15585\/mmwr.mm7246e1","article-title":"Vital signs: missed opportunities for preventing congenital syphilis - 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