Prior to 076 protocol the perinatal HIV transmission rate in our program was 25%. We implemented ACTG 076 protocol in our program starting September 1, 1994. Uninfected infants had at least 2 negative PCRs at > 1 mo of age and at least 1 of these > 3 month of age. Every infant born to HIV infected mothers between 9/1/94 and 9/30/95 was reviewed to determine the success of ACTG 076 protocol. 40 infant-mother pairs were enrolled in the 12-month period. All 40 infants received ZDV per protocol. Of the 40 mothers 27 (68%) received ZDV per protocol, 4(10%) only in pregnancy, 2 (5%) only during labor& delivery; 3 received no ZDV and no information was available on 4 mothers. 27 mother-infant pairs (68%) received ZDV per protocol and none of the infants are infected (13 infants are >03 mo of age). Of the remaining 13 mother-infant pairs only the infants received ZDV per protocol and all remain uninfected to this point (5 > 3 mo of age). Only 2 (5%) of the 40 infants are infected (both PCR positive at birth) one infant's mother did not receive any prenatal care and delivered at home and the other infant's mother only received ZDV during labor & delivery. The transmission rate in our program decreased from 25% to 5%, a decrease of 80%, if we exclude the 2 babies infected at birth we have 100% prevention.

Our data suggests that ACTG 076 can be effectively implemented in a community program outside the research setting. Although the numbers are small it is suggested that all children should be given ZDV regardless if the mother received ZDV or not.