Rapid HIV Testing and Prevention of Perinatal HIV Transmission in High-Risk Maternity Hospitals in St. Petersburg, Russia
April 4, 2008
To evaluate the effectiveness of an HIV rapid testing (RT) program, the researchers offered point-of-care RT -- including antiretroviral prophylaxis for positive women and their infants -- to pregnant women with no or incomplete HIV testing results (negative tests at From April 13, 2004, to April 13, 2005, 89.2 percent of eligible women (3,671/4,117) underwent RT, of whom 90.4 percent received results prior to delivery. Among all women who underwent RT, HIV prevalence was 2.7 percent (100/3,671); among previously untested women, prevalence was 6.5 percent (90/1,375). The incidence of HIV seroconversion among women with previous negative tests during pregnancy was 0.4 percent (10/2,296). Adjustment found the main predictor of receiving RT results post delivery was late admission. Among HIV-exposed infants, 97.9 percent (92/94) received prophylaxis; 61.7 percent (58/94) had available follow-up data, and 8.6 percent (5/58) met criteria for definitive or presumptive HIV infection.
"The RT program achieved timely detection of HIV-infected women in labor with unknown HIV status and effectively prevented perinatal HIV transmission," the authors concluded.
Am J Obstetrics & Gynecology
2.2008; Vol. 198; No. 2: P. 183.e1-183.e7; Dmitry M. Kissin, MD, MPH; Natalia Akatova, MD; Aza G. Rakhmanova, MD, MPH; Elena N. Vinogradova, MD, PhD; Evgeny E. Voronin, MD, PhD; Denise J. Jamieson, MD, MPH; M. Kathleen Glynn, DVM, MPVM; Alexey Yakovlev, MD, PhD; Joanna Robinson, MSc; William C. Miller, MD, PhD, MPH; Susan Hills, MS, PhD