title: Pilot study of expedited HIV-1 testing of women in labor at an inner-city hospital in New York City.
abstract: To evaluate the feasibility of offering voluntary counseling and expedited human immunodeficiency virus (HIV) testing to women in labor, and to assess the characteristics of two rapid HIV assays compared with results from an expedited standard enzyme immunoassay (EIA), with Western blot confirmation, as indicated, we undertook a pilot study immediately prior to enactment of New York State regulations (August 1999) requiring expedited testing of laboring women (or newborns) with undocumented HIV status. From June 9, 1999 through July 2, 1999, we offered HIV counseling and testing (C&T) to all medically stable women in active labor, 106 of 125 (85%) of whom accepted. One woman was confirmed HIV-1 seropositive. Rapid assay sensitivity and specificity were: SUDS 100 and 98%, and Multispot 100 and 100%, respectively in comparison with 100 and 99% for the standard EIA. The positive predictive values (PPV) were SUDS 33%; Multispot 100%; and EIA 50%. While our sample size was small, it appears that the accuracy of rapid and expedited HIV assays may be improved by requiring two different reactive assays before informing women of HIV-seropositive results or initiating antiretroviral treatment.
authors.affiliation: Department of Epidemiology and Social Medicine, AIDS Research Program and Montefiore Medical Center/Albert Einstein College of Medicine, New York, Bronx 10467, USA.
authors.forename: M P
authors.initials: MP
authors.lastname: Webber
authors.forename: P
authors.initials: P
authors.lastname: Demas
authors.forename: E
authors.initials: E
authors.lastname: Enriquez
authors.forename: R
authors.initials: R
authors.lastname: Shanker
authors.forename: W
authors.initials: W
authors.lastname: Oleszko
authors.forename: S T
authors.initials: ST
authors.lastname: Beatrice
authors.forename: E E
authors.initials: EE
authors.lastname: Schoenbaum
mesh_terms: D000293:Adolescent; D000328:Adult; D015153:Blotting, Western / Q000379:methods; D005260:Female; D015483:HIV Antibodies / Q000097:blood; D015658:HIV Infections / Q000175:diagnosis* / Q000517:prevention & control / Q000635:transmission; D015497:HIV-1 / Q000276:immunology*; D006801:Humans; D007124:Immunoenzyme Techniques / Q000379:methods; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control; D007743:Labor, Obstetric; D009519:New York City; D010865:Pilot Projects; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis* / Q000821:virology; D011295:Prenatal Care; D012680:Sensitivity and Specificity; D013997:Time Factors
chemical_list: D015483:HIV Antibodies