Universal newborn screening for human immunodeficiency virus (HIV) has been mandatory in New York State since 1997. The goal of screening is to prevent mother-to-child transmission by using approaches including antiretroviral therapy in the newborn and lactating mother. Screening is performed at the Wadsworth Center using an enzyme-linked immunosorbent assay that detects maternal antibodies in dried blood spots from newborns. Newborns who screen positive are referred to an infectious disease specialist for follow-up. Wadsworth Center’s Newborn Screening Program shares screening results with the New York State AIDS Institute, which is responsible for ensuring that infants exposed to human immunodeficiency virus receive appropriate and timely diagnostic testing and care.
Dr. Norma Tavakoli and colleagues from Wadsworth Center’s Newborn Screening Program have published a manuscript describing results from screening approximately 2.3 million newborns for human immunodeficiency virus-1 antibodies. Amongst 4,018 screen-positive newborns referred for follow-up, mother-to-child transmission was confirmed in 16 newborns (0.4%), 3,930 were uninfected (97.8%), 53 were lost to follow-up or were deceased (1.3%), and 19 newborns were considered to have false-positive results (0.5%). Mother-to-child transmission occurred in one in 144,162 newborns screened during the study period, while one in 577 infants were considered to be at risk of vertical transmission. The number of newborns who screened positive for human immunodeficiency virus antibodies and were therefore at risk for mother-to-child transmission, as well as transmission numbers, have both fallen from 2011 to 2024. Mother-to-child transmission in New York State has been below 1% since 2015.
Delays in diagnosis and treatment of infected newborns can lead to significant morbidity and mortality. Sharing our experience is important because the New York State Newborn Screening Program is the only program in the United States that mandates universal screening for human immunodeficiency virus. The primary purpose of screening is to identify infants at risk for mother-to-child transmission who would otherwise go undetected, including infants for whom the mother’s status is unknown or when the mother was infected late in pregnancy and has not yet been identified as positive for human immunodeficiency virus. Perinatal human immunodeficiency virus transmission can occur during pregnancy, childbirth or breastfeeding and is the main cause of infection in pediatric cases.
Tavakoli NP, Pearce M, Sejour R, Stansfield DM, Erickson M, McMahon R. Statewide Universal Newborn Screening for Human Immunodeficiency Virus. Int J Neonatal Screen. 2026 Oct 2;12(4):81. doi: 10.3390/ijns12040081. PMID: 42924758; PMCID: PMC13692447.