Despite federal guidelines that have not recommended single-drug therapy for pregnant people since the 1990s, a new analysis published in the Journal of Health Care for the Poor and Underserved found that, as late as 2014, Black womenin South Carolina were still being prescribed HIV monotherapy.
“African-American women were also more likely to take monotherapy during pregnancy, a strategy that has not been recommended for the prevention of perinatal HIV transmission since the 1990s,” wrote Gweneth Lazenby, MD, associate professor of obstetrics and gynecology at the Medical University of South Carolina, and colleagues. “Our findings suggest that African-American women with HIV infection in South Carolina were less likely than others to receive guideline-based treatment for HIV during pregnancy.”
The Black maternal mortality crisis in the United States is well documented, and poor birth outcomes for Black women are higher than their white peers. What’s more, Black women living with HIV have also been found to receive less HIV care after childbirth. Previous research has already shown that women with HIV who have unintended pregnancies are more likely to have higher viral loads. Now, this new analysis suggests that women who don’t receive prenatal care during their pregnancies also have higher viral loads, and their infants experience worse outcomes.