Rapid HIV testing and prevention of perinatal HIV transmission in high-risk maternity hospitals in St. Petersburg, Russia.
OBJECTIVE
The purpose of this study was to evaluate the effectiveness of a human immunodeficiency virus (HIV) rapid testing (RT) program.


METHODS
From April 13, 2004, to April 13, 2005, pregnant women at 2 high-risk maternity hospitals with no or incomplete HIV testing results (negative tests at <34 weeks, none thereafter) were offered point-of-care RT, with antiretroviral prophylaxis for RT-positive women and their infants.


RESULTS
Overall, 89.2% of eligible women (3671/4117) underwent RT, of whom 90.4% received results before delivery. HIV seroprevalence among all women who underwent RT was 2.7% (100/3671 women); among previously untested women, seroprevalence was 6.5% (90/1375 women); the incidence of HIV seroconversion among women with previous negative tests during pregnancy was 0.4% (10/2296 women). After adjustment, the main predictor of receiving RT results after delivery was late admission. Among HIV-exposed infants, 97.9% (92/94) received prophylaxis; 61.7% (58/94) had available follow-up data, and 8.6% (5/58) met criteria for definitive or presumptive HIV infection.


CONCLUSIONS
The RT program achieved timely detection of HIV-infected women in labor with unknown HIV status and effectively prevented perinatal HIV transmission.
Kissin
Dmitry M
DM
Centers for Disease Control and Prevention, Atlanta, GA 30341, USA. DKissin@cdc.gov
Akatova
Natalia
N
Rakhmanova
Aza G
AG
Vinogradova
Elena N
EN
Voronin
Evgeny E
EE
Jamieson
Denise J
DJ
Glynn
M Kathleen
MK
Yakovlev
Alexey
A
Robinson
Joanna
J
Miller
William C
WC
Hillis
Susan
S
D005260:Female; D006678:HIV / Q000235:genetics / Q000302:isolation & purification; D015658:HIV Infections / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology / Q000517:prevention & control / Q000635:transmission; D015528:HIV Seroprevalence; D006771:Hospitals, Maternity; D006801:Humans; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D008427:Maternal Health Services / Q000706:statistics & numerical data; D017063:Outcome Assessment, Health Care; D011237:Predictive Value of Tests; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology / Q000517:prevention & control; D011296:Prenatal Diagnosis; D011933:Reagent Kits, Diagnostic / Q000706:statistics & numerical data*; D012426:Russia / Q000453:epidemiology
D011933:Reagent Kits, Diagnostic