title: Point-of-care HIV testing at antenatal care and maternity sites: experience in Battambang Province, Cambodia.
abstract: Worldwide elimination of HIV transmission from mother-to-child is theoretically achievable. In Cambodia, antenatal care (ANC) prevalence has dropped from 1.6% (2003) to 0.71% (2009). However, success in minimizing vertical transmission has been limited by low testing uptake at ANC and delivery. We trained midwives in counselling and performance of an HIV rapid test, incorporated point-of-care testing into routine antenatal and maternity services and determined acceptability, feasibility, accuracy, cost and yield after one year. In all, 97.3% of ANC clients and 73.0% of maternity admissions had unknown HIV status. Testing was offered to 97.6% and 95.0% of untested ANC and maternity clients, respectively. Acceptance rates were 95.5% and 99.4%. Partner testing rate was 38.6%. HIV was diagnosed in 0.1% of ANC clients, 0.4% of partners and 0.9% of women at delivery. For an operational district with an average population of 158,000, point-of-care testing was estimated in one year to identify 19 HIV-infected pregnant women, nine men, 14 discordant couples and 16 exposed infants who otherwise would have not received prophylaxis. Cost was less than $3.75 per person tested. Point-of-care testing during ANC and at delivery is feasible, acceptable and contributes to reducing mother-to-child transmission.
authors.affiliation: US CDC Global AIDS Program, Phnom Penh, Cambodia. hellert@et.cdc.gov
authors.forename: T
authors.initials: T
authors.lastname: Heller
authors.forename: S
authors.initials: S
authors.lastname: Kunthea
authors.forename: E
authors.initials: E
authors.lastname: Bunthoeun
authors.forename: K
authors.initials: K
authors.lastname: Sok
authors.forename: C
authors.initials: C
authors.lastname: Seuth
authors.forename: W P
authors.initials: WP
authors.lastname: Killam
authors.forename: T
authors.initials: T
authors.lastname: Sovanna
authors.forename: V
authors.initials: V
authors.lastname: Sathiarany
authors.forename: K
authors.initials: K
authors.lastname: Kanal
mesh_terms: D002160:Cambodia; D005260:Female; D015658:HIV Infections / Q000175:diagnosis* / Q000517:prevention & control*; D006801:Humans; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data; D010342:Patient Acceptance of Health Care; D019095:Point-of-Care Systems; D011247:Pregnancy; D011295:Prenatal Care / Q000379:methods* / Q000706:statistics & numerical data; D011446:Prospective Studies