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LEGEND:
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| Rapid HIV-1 Antibody Testing during Labor and Delivery for Women of Unknown HIV Status: A Practical Guide and Model Protocol
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V. Conclusion
Until all HIV-infected pregnant women are tested for HIV infection
during prenatal care, the promise of the findings of AIDS
Clinical Trials Group Protocol 076, the first study to demonstrate the
efficacy of an ARV medication (i.e., AZT) to substantially
reduce perinatal HIV transmission, and the findings of other important
perinatal HIV prevention studies—that perinatal HIV transmission
can largely be prevented and virtually eliminated—cannot
be realized. Although efforts are in place to improve access
to prenatal care, prenatal HIV testing, and ARV prophylaxis,
opportunities to prevent perinatal HIV transmission continue
to be missed, and infants acquire HIV infection. The routine
use of rapid HIV testing and medical interventions in labor
and delivery settings provides a final opportunity to reduce
the
effect of those missed opportunities for prevention. It is
recommended that hospitals adopt a policy of routine rapid HIV testing
by using an opt-out approach for women whose HIV status is unknown
when presenting to the labor and delivery. It is
recognized that implementing rapid testing programs in labor
and delivery settings
poses challenges. However, clinicians in labor and delivery
settings frequently make complex medical decisions, implement
emergency
life-saving interventions, and discuss sensitive and difficult
personal information with patients. This document is intended
to assist clinicians by adding another important tool to
their repertoire of clinical screening and HIV prevention
interventions.
For inquiries
or comments, please e-mail Margaret A. Lampe, RN (mlampe@cdc.gov).
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