Rate of Mother-to-Child AIDS Is Down Sharply

The number of babies who got AIDS from their mothers dropped by two-thirds from 1992 to 1997, largely because of prenatal treatment with the drug AZT, a study has found.

The number of babies who developed AIDS after being infected with HIV before or during birth peaked at 907 in 1992, then declined 67 percent over the next five years, to 297 in 1997, researchers from the federal Centers for Disease Control and Prevention report in today's Journal of the American Medical Association.

The researchers believe the number of babies born HIV-infected is higher, since it can take years for HIV to develop into AIDS.

Only 32 states collect information on HIV infection in newborns, but the CDC estimates that 1,650 babies caught the virus from their mothers in 1991, at the epidemic's peak. By 1996, that number had fallen to 480, a 71 percent drop, said Mary Lou Lindegren, an epidemiologist with the CDC and the study's lead author.

Scientists discovered in 1994 that treatment with AZT, now called zidovudine, reduced a newborn's risk of catching HIV from 26 percent to 8 percent. In that study, the drug was given to HIV-infected women during pregnancy and labor and to the newborn for the first six weeks of life, said Lynne M. Mofenson of the National Institute of Child Health and Human Development.

Since then, doctors have found that prenatal AZT can actually reduce the risk to as low as 3 percent, Mofenson noted in an editorial accompanying the study. Delivering at-risk babies by Caesarean section lowers the risk further, she said.

Also, if women are getting treatment with powerful AIDS-fighting drug regimens that can reduce virus levels in the blood to undetectable amounts, the risk may fall to less than 1 percent, she said, citing other research.

As Patients See Care, Race, Gender Matter

Patients feel they are allowed to participate more actively in their medical care when their physicians are women rather than men, while blacks feel less comfortable with white doctors, a study concluded yesterday.

Telephone surveys of 1,816 adults, which scored their answers to questions about their participation in their care and treatment, found "significantly" higher ratings among those seeing women physicians than male ones.

The study also showed that black and white patients rated their visits with same-race physicians as significantly more participatory than those with doctors of a different race than their own.

Among other findings of the study, which was published in today's Journal of the American Medical Association, older patients age 40 to 65 rated their visits as more participatory than patients younger than 30. Patients who had better health and those who had known their doctors three years or longer rated their visits higher than those in poorer health or those with a shorter physician relationship.

Researchers said the study's findings pointed to the need for more minority physicians and more training in communication skills for physicians and nurses.