What is the goal of the
One Test. Two Lives. campaign?
The One Test. Two Lives.
campaign focuses on ensuring that all women
have the opportunity to get tested for HIV early in their pregnancy.
Is the One Test. Two Lives. campaign directed toward pregnant
women?
No, it is directed toward health
care providers who work with pregnant women,
including obstetricians, certified
nurse-midwives, and nurses in obstetrical
practices. The campaign aims to assist these
obstetrical providers in encouraging all of
their pregnant patients to get tested for
HIV. A 2001 study by Royce et al. showed that
patients trust their providers’ judgment and
strong provider endorsement motivates
pregnant women to accept testing. In this
study of 1,362 pregnant women, nearly 90%
were offered prenatal HIV screening. About
75% of those who were offered testing
accepted it. Most notably, 93% of the women
who felt that their providers strongly
recommended HIV screening accepted the test.
To what degree can early
detection and treatment of the mother’s HIV
infection protect a baby from perinatal HIV
transmission?
Perinatal HIV transmission
rates are 2% or less when antiretroviral
therapy is initiated and adhered to during
pregnancy. The figure is 25% for women who
receive no preventive treatment. When
antiretroviral therapy is begun intrapartum,
the rate of transmission is approximately
10%.
Is lack of prenatal HIV
screening a big problem in the United
States?
Approximately 40% of the mothers of HIV-infected infants
born in the United States in 2000 were not known to have HIV
before delivery. So clearly not all pregnant women are being
screened for HIV during pregnancy.
How many babies in the
United States are born with HIV each year?
Since the 1990s, the number of children born with HIV has declined dramatically (from almost 1700 per year before interventions to less than 150 per year, an 85% decline). Despite the great progress we’ve made in reducing mother-to-child HIV transmission, even one HIV-infected newborn is too many. We must remain vigilant by continuing to invest in perinatal HIV screening and prevention to sustain our progress, and bring the number of infected newborns down even further
What information can be
provided to a pregnant patient who refuses
HIV testing to help her understand the
importance of receiving the test?
It is worthwhile and in line
with current recommendations to pursue the
subject of HIV testing after an initial
refusal. One Test. Two Lives. offers
a
tool with suggested
responses to common objections to HIV
screening. These can be helpful in
encouraging a patient to be tested. Of
course, keep in mind that every woman does
have the right to refuse testing.
Is it beneficial to test a
pregnant patient for HIV if she does not
present until labor and delivery?
Even if the patient has had
no prenatal care or has refused testing
until labor and delivery, a rapid test can
be done at that time and antiretroviral
therapy can be started, if warranted. When
antiretroviral therapy is begun intra
partum, the rate of transmission is
approximately 10%.
Is there another testing
option besides the standard blood test for
patients who are afraid of needles?
Yes, the FDA has approved a
test that uses oral fluid to detect HIV. You
can learn more about this type of testing by
visiting the
rapid testing section of the CDC
HIV/AIDS prevention Web site.
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