Prevalence of hepatitis B, hepatitis C, and human immunodeficiency virus infection among women attending prenatal clinics in San Juan, Puerto Rico, from 1989-1990.

OBJECTIVE: To evaluate the prevalence of hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) among pregnant women in Puerto Rico. METHODS: An anonymous serosurvey was conducted in four prenatal clinics in San Juan, Puerto Rico, involving women presenting consecutively for their first prenatal visit. RESULTS: Nineteen of 997 pregnant women (1.9%, 95% confidence interval [CI] 1.2-3.0) tested positive for HCV antibody (anti-HCV), and eight (0.8%, 95% CI 0.4-1.6) were HIV seropositive. Of the 992 women for whom serum samples were tested for HBV markers, 91 (9.2%, 95% CI 7.5-11.2) had evidence of past or current HBV infection, and four (0.4%, 95% CI 0.1-1.1) were HBV carriers. The age-specific HBV prevalence ranged from 4.1% among women 15-19 years old to 18.5% among those at least 30 years old (P < .001, chi 2 test for trend). Anti-HCV prevalence was also higher among women at least 30 years old compared to younger women (3.1 versus 1.9%; prevalence ratio 1.6, 95% CI 0.6-4.9), although the difference was not statistically significant. Anti-HCV prevalence was higher among women with past or current HBV infection than among women who were not infected (7.7 versus 1.3%; prevalence ratio 5.8, 95% CI 2.3-14.3). CONCLUSIONS: The prevalence of chronic HBV and HCV infection among pregnant women tested in San Juan, Puerto Rico, is comparable to that among pregnant women in the United States. The prevalence of HIV infection among pregnant women in San Juan is higher than among childbearing women in the United States.

Sentinel surveillance of human immunodeficiency virus infection in women seeking reproductive health services in the United States, 1988-1989. The Field Services Branch.

Cases of AIDS among women of reproductive age have increased dramatically since 1981; nearly a third of all cases among females were reported in 1990 alone. Surveillance of human immunodeficiency virus (HIV) infection among women is essential for monitoring the spread of HIV over time and identifying specific populations and geographic areas in need of HIV counseling, testing, and prevention services. Blinded (unlinked) serologic surveys were conducted in the United States and Puerto Rico in sentinel clinics providing reproductive health services to women, including family planning, prenatal care, and abortion services. Seventy-eight of 94 clinics (83%) in 30 cities conducting surveys during 1988 and 1989 detected at least one HIV-positive woman. Clinic-specific prevalence ranged from 0-2.28% (median 0.22%), with rates over 1% occurring in clinics predominantly on the East Coast and in Puerto Rico. Seroprevalence varied by primary type of service, race-ethnicity, and age group. Median rates were higher in clinics offering prenatal services and lower in abortion and family planning clinics in the same cities. In general, women 25-29 years of age showed the highest median rate of infection (0.32%), and rates were higher among black women (median 0.34%) than among Hispanic (median 0.11%) and white women (median 0%). Our data indicate the need to educate women about recognizing and reducing their risk of HIV infection. Reproductive health clinics with high seroprevalence should implement voluntary HIV counseling and testing with appropriate follow-up clinical evaluation and referral for infected women. Clinics with low prevalence should seize the opportunity to enhance HIV education and prevention efforts.