title: Assessment of a rapid HIV test strategy during labor: a pilot study from Rio de Janeiro, Brazil.
abstract: OBJECTIVE
  To use two rapid human immunodeficiency virus (HIV) tests at labor, measure test acceptance and performance, and measure HIV prevalence in these women.
  
  
  METHODS
  Between February and October 2000, two rapid tests (Determine; Abbott, Chicago, IL, U.S.A. and Double Check; Orgenics, Yavne, Israel) were used in three public maternities in Rio de Janeiro, Brazil. Enzyme-linked immunosorbent assay (ELISA) and Western blot (WB) analysis confirmed positive and discordant results.
  
  
  RESULTS
  Of the 858 patients who were enrolled, the mean gestational age was 36 weeks (median = 39, mode = 40) and 17 (2%) refused testing. Of the 841 patients tested, 13 were positive by both tests, which represents a 1.5% prevalence (95% confidence interval: 0.7%-2.3%); all were confirmed by ELISA and WB analysis. Seven samples gave discordant results by the rapid tests; of these, six were ELISA-negative/WB-negative and one was ELISA-negative/WB-indeterminate. The positive predictive value for samples that were positive by both rapid tests simultaneously was 100%.
  
  
  CONCLUSIONS
  Two rapid HIV tests used at labor were well accepted (98%). When the combined results of the two rapid tests (but not a single rapid test) were analyzed, this strategy was as efficient as the standard ELISA and WB HIV strategy for correctly classifying individuals.
authors.affiliation: Federal University of Rio de Janeiro, Rio de Janeiro, Brazil. susie@hucff.ufrj.br
authors.forename: S A
authors.initials: SA
authors.lastname: Nogueira
authors.forename: J S
authors.initials: JS
authors.lastname: Lambert
authors.forename: A L
authors.initials: AL
authors.lastname: Albuquerque
authors.forename: R
authors.initials: R
authors.lastname: Rodrigues
authors.forename: S
authors.initials: S
authors.lastname: Reis
authors.forename: R
authors.initials: R
authors.lastname: Bornia
authors.forename: M
authors.initials: M
authors.lastname: Dias
authors.forename: R
authors.initials: R
authors.lastname: Barbosa
authors.forename: D
authors.initials: D
authors.lastname: Sztanjbock
authors.forename: A L
authors.initials: AL
authors.lastname: Santos
authors.forename: W
authors.initials: W
authors.lastname: Blattner
authors.forename: N T
authors.initials: NT
authors.lastname: Constantine
mesh_terms: D015153:Blotting, Western / Q000379:methods; D001938:Brazil / Q000453:epidemiology; D004797:Enzyme-Linked Immunosorbent Assay / Q000379:methods; D005260:Female; D015658:HIV Infections / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology / Q000276:immunology; D015497:HIV-1 / Q000276:immunology / Q000302:isolation & purification*; D006801:Humans; D007743:Labor, Obstetric; D011247:Pregnancy; D015995:Prevalence; D013997:Time Factors