Objective: This study was conducted to evaluate the rollout of rapid HIV testing as part of an emergency Prevention of Perinatal HIV Transmission Program. Specifically, HIV prevalence in this population, the reason(s) for performing the rapid HIV test, and compliance with recommendations for antiretroviral prophylaxis were assessed. Methods: Since November 2011, all women presenting to a tertiary LDR unit with unknown HIV status or with ongoing risk of HIV infection since their last HIV test were offered rapid HIV testing. Through retrospective chart review, demographic data, HIV risk and prior testing history, and antiretroviral prophylaxis data were collected and descriptive statistics were performed. Results: One hundred and fourteen rapid HIV tests were conducted and there were two preliminary reactive rapid results (one true positive, one false positive). None of the infants were HIV infected. Sixty-three percent of women had multiple risk factors for HIV acquisition, most commonly intravenous drug use (54%). Forty-four percent of women were within the 4-week seroconversion window period at the time of delivery; 25% of these women and 52% of their infants received prophylactic drug therapy. Conclusion: Rapid HIV testing identified a high-risk cohort and enabled intensive management of a newly diagnosed HIV positive pregnancy and potentially exposed infant, successfully preventing perinatal HIV transmission. Risk factors for HIV acquisition were ongoing within the seroconversion window period for over half of the women, impacting the utility of the test in eliminating unnecessary antiretroviral prophylaxis in this population, as prophylaxis is recommended despite a negative rapid HIV test in these cases.
Saunders et al. (Thu,) studied this question.