Rapid intrapartum or postpartum HIV testing at a midwife obstetric unit and a district hospital in South Africa.
OBJECTIVE
To compare the prepartum and postpartum feasibility and acceptance of voluntary counseling and rapid testing (VCT) among women with unknown HIV status in South Africa.


METHODS
Eligible women were randomized according to the calendar week of presentation to receive VCT either while in labor or after delivery.


RESULTS
Of 7238 women approached, 542 (7.5%) were eligible, 343 (63%) were enrolled, and 45 (13%) were found to be HIV infected. The proportions of eligible women who accepted VCT were 66.8% (161 of 241) in the intrapartum arm and 60.5% (182 of 301) in the postpartum arm, and the difference of 6.3% (95% CI, -1.8% to 14.5%) was not significant. The median times (44 and 45 minutes) required to conduct VCT were also similar in the 2 arms. In the intrapartum arm, all women in true labor received their test results before delivery and all those found to be HIV positive accepted prophylaxis with nevirapine before delivery.


CONCLUSIONS
Rapid testing in labor wards for women with an unknown HIV status is feasible and well accepted, and allows for a more timely antiretroviral prophylaxis than postpartum testing.
Department of Obstetrics and Gynaecology, Faculty of Health Sciences, Stellenbosch University and Tygerberg Hospital, Stellenbosch, South Africa. gbth@sun.ac.za
Gerhard B
GB
Theron
David E
DE
Shapiro
Russell
R
Van Dyke
Mae P
MP
Cababasay
Jeanne
J
Louw
D Heather
DH
Watts
Elizabeth
E
Smith
Marc
M
Bulterys
Robert
R
Maupin
D000293:Adolescent; D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use; D016000:Cluster Analysis; D005240:Feasibility Studies; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D006679:HIV Seropositivity; D006767:Hospitals, District; D006801:Humans; D008403:Mass Screening / Q000379:methods*; D008880:Midwifery; D019829:Nevirapine / Q000627:therapeutic use; D010342:Patient Acceptance of Health Care; D049590:Postpartum Period; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis* / Q000188:drug therapy; D011446:Prospective Studies; D013019:South Africa; D013997:Time Factors; D055815:Young Adult
D019380:Anti-HIV Agents; D019829:Nevirapine
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