Skip to main content

Advertisement

SpringerLink
Log in

Sustainability of Statewide Rapid HIV Testing in Labor and Delivery

  • Original Paper
  • Published:
AIDS and Behavior Aims and scope Submit manuscript

Abstract

The objective was to assess sustainability of a statewide program of HIV rapid testing (RT) for pregnant women presenting for delivery with unknown HIV status. This is a population-based retrospective cohort study of women delivered in Illinois hospitals (2012–15). Deidentified data on RT metrics from state-mandated surveillance reports were compared using descriptive statistics and non-parametric tests of trend. Over 95% of the 608,408 women delivered had documented HIV status at presentation. The rate of undocumented HIV status rose from 4.19 to 4.75% (p < 0.001). However, overall 99.60% of women with undocumented status appropriately received RT and the proportion who did not receive RT declined (p = 0.003). The number of neonates discharged with unknown HIV status declined (p = 0.011). RT identified 23 new HIV diagnoses, representing 4.62% of maternal HIV diagnoses. In conclusion, statewide perinatal HIV RT resulted in nearly 100% of Illinois mother-infant dyads with known HIV status. Sustained RT completion represents an important prevention safety net.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Panel on Treatment of HIV-Infected Pregnant Women and Prevention of Perinatal Transmission. Recommendations for use of antiretroviral drugs in pregnant HIV-1-infected women for maternal health and interventions to reduce perinatal HIV transmission in the United States 2016 [updated 7 June 2016, 28 June 2016]. http://aidsinfo.nih.gov/contentfiles/lvguidelines/PerinatalGL.pdf.

  2. Centers for Disease Control and Prevention Division of HIV/AIDS Prevention. Pregnant Women, Infants and Children: Elimination of Mother-to-Child HIV Transmission (EMCT) in the United States: Centers for Disease Control and Prevention; 2017 [updated 22 February 2017, 16 July 2017]. https://www.cdc.gov/hiv/group/gender/pregnantwomen/emct.html.

  3. Sperling R, Shapiro D, Coombs R, Todd J, Herman S, McSherry G, et al. Maternal viral load, zidovudine treatment, and the risk of transmission of human immunodeficiency virus type 1 from mother to infant. Pediatric AIDS Clinical Trials Group Protocol 076 Study Group. N Engl J Med. 1996;335(22):1621–9.

    Article  CAS  PubMed  Google Scholar 

  4. Cooper E, Charurat M, Mofenson L, Hanson I, Pitt J, Diaz C, et al. Combination antiretroviral strategies for the treatment of pregnant HIV-1 infected women and prevention of perinatal HIV-1 transmission. J Acquir Immune Defic Syndr. 2002;29(5):484–94.

    Article  CAS  PubMed  Google Scholar 

  5. Townsend C, Cortina-Borja M, Peckham C, de Ruiter A, Lyall H, Tookey P. Low rates of mother-to-child transmission of HIV following effective pregnancy interventions in the United Kingdom and Ireland, 2000–2006. AIDS. 2008;22(8):973–81.

    Article  PubMed  Google Scholar 

  6. Chou R, Cantor A, Zakher B, Bougatsos C. Screening for HIV in pregnant women: systematic review to update the 2005 U.S. Preventive Services Task Force recommendation. Ann Intern Med. 2012;157(10):719–28.

    Article  PubMed  Google Scholar 

  7. American College of Obstetricians and Gynecologists Committee on Obstetric Practice and HIV Expert Work Group. Prenatal and perinatal human immunodeficiency virus testing: expanded recommendations, Committee Opinion Number 635. Obstet Gynecol. 2015;125:1544–7.

    Article  Google Scholar 

  8. Moyer V, U.S. Preventive Services Task Force. Screening for HIV: U.S. preventive services task force recommendation statement. Ann Intern Med. 2013;159:51–60.

    Article  PubMed  Google Scholar 

  9. Workowski K, Bolan G, Centers for Disease Control and Prevention. Sexually transmitted diseases treatment guidelines, 2015. MMWR Recommendations and Reports. 2015;64(RR-03):1–137.

  10. Nesheim S, Taylor A, Lampe M, Kilmarx P, Fitz Harris L, Whitmore S, et al. A framework for elimination of perinatal transmission of HIV in the United States. Pediatrics. 2012;130(4):738–44.

    Article  PubMed  Google Scholar 

  11. Centers for Disease Control and Prevention. HIV Surveillance Report, 2015; vol. 27, 2016 [updated Nov 2016, 16 July 2017]. http://www.cdc.gov/hiv/library/reports/hiv-surveillance.html.

  12. Centers for Disease Control and Prevention. Pediatric HIV Surveillance 2017 [updated 19 May 2017, 19 July 2017]. https://www.cdc.gov/hiv/pdf/library/slidesets/cdc-hiv-surveillance-pediatric.pdf.

  13. Mahy M, Stover J, Kiragu K, Hayashi C, Akwara P, Luo C, et al. What will it take to achieve virtual elimination of mother-to-child transmission of HIV? An assessment of current progress and future needs. Sex Transm Infect. 2010;86(Suppl 2):ii48–55.

    PubMed  PubMed Central  Google Scholar 

  14. Whitmore S, Taylor A, Espinoza L, Shouse R, Lampe M, Nesheim S. Correlates of mother-to-child transmission of HIV in the United States and Puerto Rico. Pediatrics. 2012;129(1):e74–81.

    Article  PubMed  Google Scholar 

  15. Read J, Cohen R, Hance L, Machado E, Mussi-Pinhata M, Ceriotto M, et al. Missed opportunities for prevention of mother-to-child transmission of HIV-1 in the NISDI Perinatal and LILAC cohorts. Int J Gynaecol Obstet. 2012;119(1):70–5.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Liao C, Golden W, Anderson J, Coleman J. Missed opportunities for repeat HIV testing in pregnancy: implications for elimination of mother-to-child transmissions in the United States. AIDS Patient Care STDs. 2017;31(1):20–6.

    Article  PubMed  Google Scholar 

  17. Frange P, Chaix M, Veber F, Blanche S. Missed opportunities for HIV testing in pregnant women and children living in France. Pediatr Infect Dis J. 2014;33(2):e60–2.

    Article  PubMed  Google Scholar 

  18. American Academy of Pediatrics Committee on Pediatric AIDS. HIV testing and prophylaxis to prevent mother-to-child transmission in the United States. Pediatrics. 2008;122(5):1127–34.

    Article  Google Scholar 

  19. Centers for Disease Control and Prevention. Achievements in Public Health: Reduction in perinatal transmission of HIV infection—United States, 1985–2005. MMWR Morb Mortal Wkly Rep. 2006;55(21):592–7.

    Google Scholar 

  20. Centers for Disease Control and Prevention. Revised recommendations for HIV screening of pregnant women: Perinatal counseling and guidelines consultation. MMWR Morb Mortal Wkly Rep. 2001;50(RR19):59–86.

    Google Scholar 

  21. Illinois Perinatal HIV Prevention Act. P.A. 93-566, amended by PA 94-0910 (2006), amended by P.L. 95-702 (2007). 2003.

  22. Garcia P, Bryant A, Cohen M, Statton A, Olszewski Y. PRTII (Perinatal Rapid Testing Implementation in Illinois) Written Testimony to the House Human Services Committee on HB 4306 (12 Jan 2006) 2006 [28 June 2016]. www.aidschicago.org/resources/legacy/pdf/2006/adv_prtii_testimony.pdf.

  23. Wong A, Garcia P, Olszewski Y, Statton A, Borders A, Grobman W, et al. Perinatal HIV testing and diagnosis in Illinois after implementation of the perinatal rapid testing initiative. Am J Obstet Gynecol. 2012;207:401.e1–6.e1.

    Article  Google Scholar 

  24. AIDS Foundation of Chicago. The Illinois Perinatal HIV Prevention Law and 2006 Amendment 2006 [cited 28 June 2016]. www.aidschicago.org/resources/legacy/pdf/2006/adv_perinatal_factsheet.pdf.

  25. Pediatric AIDS Chicago Prevention Initiative. PACPI 2013 Annual Report Chicago, IL2013. Available from: www.pregnantandpositive.org/about-pacpi/financials-and-reports/.

  26. Cuzick J. A Wilcoxon-type test for trend. Stat Med. 1985;4:87–90.

    Article  CAS  PubMed  Google Scholar 

  27. Stata User’s Manual. Nptrend—test for trend across groups College Station, Texas: StataCorp LLC [16 July 2017]. 2017. http://www.stata.com/manuals/rnptrend.pdf.

  28. Birkhead G, Klein S, Warren B, Candelas A, O’Connell D, Scully M, et al. Program and policy interventions for preventing mother-to-child transmission of HIV in New York State. J Public Health Manag Pract. 2010;16(6):492–504.

    Article  PubMed  Google Scholar 

  29. Levison J, Williams L, Moore A, McFarlane J, Davila J. Increasing use of rapid HIV testing in labor and delivery among women with no prenatal care: a local initiative. Matern Child Health J. 2011;15(6):822–6.

    Article  PubMed  Google Scholar 

  30. Gaur S, Whitley-Williams P, Flash C, Jimenez E, Petrova A. Disparity in hospital utilization of rapid HIV-1 testing for women in labor with undocumented HIV status. Matern Child Health J. 2010;14(2):268–73.

    Article  PubMed  Google Scholar 

  31. Burke R, Sepkowitz K, Bernstein K, Karpati A, Myers J, Tsoi B, et al. Why don’t physicians test for HIV? A review of the US literature. AIDS. 2007;21(12):1617–24.

    Article  PubMed  Google Scholar 

  32. Arya M, Patel S, Kumar D, Zheng M, Kallen M, Street R Jr, et al. Why physicians don’t ask: Interpersonal and intrapersonal barriers to HIV testing—making a case for a patient-initiated campaign. J Int Assoc Provid AIDS Care. 2016;15(4):306–12.

    Article  PubMed  Google Scholar 

  33. Dorell C, Sutton M, Oster A, Hardnett F, Thomas P, Gaul Z, et al. Missed opportunities for HIV testing in health care settings among young African American men who have sex with men: implications for the HIV epidemic. AIDS Patient Care STDs. 2011;25(11):657–64.

    Article  PubMed  Google Scholar 

  34. Mrus J, Tsevat J. Cost-effectiveness of interventions to reduce vertical HIV transmission from pregnant women who have not received prenatal care. Med Decis Mak. 2004;24(1):30–9.

    Article  Google Scholar 

  35. Illinois Department of Public Health. Health Statistics: Provisional Tabulations (as of 15 July 2014) Births by County of Residence 2011–2013 [cited 17 Aug 2016]. 2014. www.idph.state.il.us/health/bdmd/provisional_birth.htm.

Download references

Funding

LMY and ESM are supported by the NICHD K12 HD050121-11 and HD050121-09, respectively.

Author information

Authors and Affiliations

  1. Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, 250 E. Superior Street, #5-2191, Chicago, IL, 60611, USA

    Lynn M. Yee, Emily S. Miller & Patricia M. Garcia

  2. Pediatric AIDS Chicago Prevention Initiative, Chicago, IL, USA

    Emily S. Miller, Anne Statton & Patricia M. Garcia

  3. Perinatal HIV Hotline, Northwestern Memorial Hospital, Chicago, IL, USA

    Lynn M. Yee, Emily S. Miller, Laurie D. Ayala, Sarah Deardorff Carter & Patricia M. Garcia

  4. Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, NorthShore University Health System, Chicago, IL, USA

    Ann Borders

  5. Department of Obstetrics and Gynecology, Pritzker School of Medicine, University of Chicago, Chicago, IL, USA

    Ann Borders

  6. Department of Maternal-Fetal Medicine, Palo Alto Medical Foundation, Mountain View, CA, USA

    Amy E. Wong

  7. Hektoen Institute of Medicine, Chicago, IL, USA

    Yolanda Olszewski

  8. Department of Medicine, John H. Stroger Jr Hospital of Cook County, Cook County Health & Hospital System, Chicago, IL, USA

    Mardge H. Cohen

Authors
  1. Lynn M. Yee
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Emily S. Miller
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Anne Statton
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Laurie D. Ayala
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Sarah Deardorff Carter
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Ann Borders
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Amy E. Wong
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Yolanda Olszewski
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Mardge H. Cohen
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Patricia M. Garcia
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Lynn M. Yee.

Ethics declarations

Conflicts of interest

The authors report no conflicts of interest.

Ethical Approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (PDF 17 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Yee, L.M., Miller, E.S., Statton, A. et al. Sustainability of Statewide Rapid HIV Testing in Labor and Delivery. AIDS Behav 22, 538–544 (2018). https://doi.org/10.1007/s10461-017-1920-5

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10461-017-1920-5

Keywords

Search

Navigation