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February 7, 1996

Prenatal and Neonatal HIV Testing-Reply

Author Affiliations

State University of New York Health Science Center at Brooklyn

JAMA. 1996;275(5):357-358. doi:10.1001/jama.1996.03530290027016

In Reply.  —As clinicians and researchers who have been working with HIV-infected women and children for more than a decade, we are well aware of the tremendous advances in care that the last few years have witnessed. It was not our intention to denigrate the benefits of either aggressive pediatric care or the avoidance of breast-feeding. However, two important points must be considered that put these advances into a reasonable context. First, treatment and prophylaxis in the infant and child are only palliative at this time and must be considered a secondary goal, with primary prevention with zidovudine in pregnant and delivering women clearly warranting primacy. Therefore, therapeutic strategies that focus on palliation and ignore opportunities for a "cure" via primary prevention cannot be considered optimal. Second, while we believe that all efforts should be made to convince, direct, and by all voluntary means ensure that women know their