What is the goal of the One Test. Two
Lives. campaign?
The One Test. Two Lives. campaign focuses on
ensuring that all women are 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 parturient 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 yet.
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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