title: Increasing use of rapid HIV testing in labor and delivery among women with no prenatal care: a local initiative.
abstract: Pregnant women who do not receive prenatal care and may not be aware of their HIV status are at greatest risk of transmitting HIV to their newborn. A multi-component intervention was designed and implemented to increase the use of rapid HIV testing among pregnant women with no prenatal care at labor and delivery in two county hospitals in Houston/Harris County, Texas. The intervention involved establishing a local task force including representatives from each hospital, assessing each hospital's readiness to implement rapid testing, providing educational presentations and materials, and offering individualized follow-up. Outcomes data were obtained and included the number of patients presenting with no prenatal care who received rapid HIV testing on admission. Before the intervention, both hospitals had rapid test kits available but were not using them consistently. Following the intervention, we observed a significant increase in the use of rapid HIV testing at both institutions (P < 0.001). In the 3 months immediately following the intervention, use of rapid testing at Hospital 1 increased from 7.4 to 35.3% and at Hospital 2 from 27.4 to 41.5%. At 1 year, almost 100% of women with no prenatal care at both hospitals received rapid testing. Educating staff and clinicians and implementing system-wide changes may facilitate behavior change regarding prenatal HIV testing.
authors.affiliation: Departments of Obstetrics/Gynecology and Family/Community Medicine, Northwest Health Center, Baylor College of Medicine, 1100 W. 34th St., Houston, TX 77018, USA. jlevison@bcm.edu
authors.forename: Judy
authors.initials: J
authors.lastname: Levison
authors.forename: Lena T
authors.initials: LT
authors.lastname: Williams
authors.forename: Anna
authors.initials: A
authors.lastname: Moore
authors.forename: Jenny
authors.initials: J
authors.lastname: McFarlane
authors.forename: Jessica A
authors.initials: JA
authors.lastname: Davila
mesh_terms: D015492:AIDS Serodiagnosis; D036861:Delivery, Obstetric; D005260:Female; D015483:HIV Antibodies / Q000032:analysis*; D015658:HIV Infections / Q000175:diagnosis* / Q000517:prevention & control* / Q000635:transmission; D006801:Humans; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D007743:Labor, Obstetric; D008403:Mass Screening / Q000379:methods; D008505:Medical Staff, Hospital / Q000193:education; D011247:Pregnancy; D037841:Pregnant People; D011295:Prenatal Care; D013781:Texas / Q000453:epidemiology
chemical_list: D015483:HIV Antibodies