title: Introduction of rapid syphilis testing in antenatal care: A systematic review of the impact on HIV and syphilis testing uptake and coverage.
abstract: BACKGROUND
  Global guidelines recommend universal syphilis and HIV screening for pregnant women. Rapid syphilis testing (RST) may contribute toward achievement of universal screening.
  
  
  OBJECTIVE
  To examine the impact of RST on syphilis and HIV screening among pregnant women.
  
  
  METHODS
  We searched MEDLINE for English- and non-English language articles published through November, 2014.
  
  
  METHODS
  We included studies that used a comparative design and reported on syphilis and HIV test uptake among pregnant women in low- and middle-income countries (LMICs) following introduction of RST.
  
  
  METHODS
  Data were extracted from six eligible articles presenting findings from Asia, Africa, and Latin America.
  
  
  RESULTS
  All studies reported substantial increases in antenatal syphilis testing following introduction of RST; the latter did not appear to adversely impact antenatal HIV screening levels at sites already offering rapid HIV testing and may increase HIV screening among pregnant women in some settings. Qualitative data revealed that women were highly satisfied with RST. Nevertheless, ensuring adequate training for healthcare workers and supplies of commodities were cited as key implementation barriers.
  
  
  CONCLUSIONS
  RST may increase antenatal syphilis and HIV screening and contribute to the improvement of antenatal care in LMICs.
authors.affiliation: Rollins School of Public Health, Emory University, Atlanta, GA, USA. Electronic address: alswart@emory.edu.
authors.forename: Andrea
authors.initials: A
authors.lastname: Swartzendruber
authors.affiliation: Rollins School of Public Health, Emory University, Atlanta, GA, USA.
authors.forename: Riley J
authors.initials: RJ
authors.lastname: Steiner
authors.affiliation: Global AIDS Program, Centers for Disease Control Prevention, Atlanta, GA, USA.
authors.forename: Michelle R
authors.initials: MR
authors.lastname: Adler
authors.affiliation: Division of STD Prevention, International Activities Unit, Centers for Disease Control and Prevention, Atlanta, GA, USA.
authors.forename: Mary L
authors.initials: ML
authors.lastname: Kamb
authors.affiliation: Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland.
authors.forename: Lori M
authors.initials: LM
authors.lastname: Newman
mesh_terms: D000328:Adult; D000349:Africa; D001208:Asia; D003906:Developing Countries; D005260:Female; D015658:HIV Infections / Q000175:diagnosis* / Q000635:transmission; D006801:Humans; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control; D007843:Latin America; D008403:Mass Screening; D017060:Patient Satisfaction; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis* / Q000276:immunology; D011296:Prenatal Diagnosis / Q000379:methods / Q000523:psychology / Q000706:statistics & numerical data*; D013587:Syphilis / Q000175:diagnosis* / Q000635:transmission; D013588:Syphilis Serodiagnosis / Q000523:psychology / Q000706:statistics & numerical data*
keywords: HIV; Point-of-care test; Pregnancy; Screening; Syphilis