The Effect of Rapid HIV-1 Testing on Uptake of Perinatal HIV-1 Interventions: A Randomized Clinical Trial

AIDS. 2003 Jan 3;17(1):113-8. doi: 10.1097/00002030-200301030-00015.

Abstract

Objective: We examined whether HIV-1 testing using a rapid assay increases the proportion of pregnant women obtaining HIV-1 results and the uptake of perinatal HIV-1 interventions.

Methods: Pregnant women attending public health clinics in Nairobi were offered voluntary counselling and testing for HIV-1. Consenting women were randomly assigned to receive either rapid or conventional HIV-1 testing. Women randomly assigned to rapid testing were allowed to receive same-day results or to return later. The results for women randomly assigned to conventional enzyme-linked immunosorbent assay (ELISA) testing were available after 7 days. HIV-1-infected women were referred for antiretroviral prophylaxis to prevent mother-to-child transmission of HIV-1.

Results: Among 1282 women offered voluntary HIV-1 testing and counselling, 1249 accepted testing, of whom 627 were randomly assigned to rapid testing and 622 to conventional testing. The median duration between testing and obtaining results was 0 days for women who received rapid testing compared with 11 days for women who received conventional testing. The percentage receiving HIV-1 results was significantly higher among women who received rapid testing compared with conventional testing. Of 161 HIV-1-seropositive women, only 24 received antiretroviral prophylaxis. The uptake of perinatal HIV-1 interventions did not differ between HIV-1-seropositive women randomly assigned to rapid testing or conventional ELISA testing.

Conclusion: Rapid HIV-1 testing significantly increased the proportion of women receiving HIV-1 results, which is important for sexual and perinatal HIV-1 prevention. The challenge remains to improve the uptake of perinatal HIV-1 interventions among HIV-1-seropositive women.

Publication types

  • Clinical Trial
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • AIDS Serodiagnosis / methods*
  • Adolescent
  • Adult
  • Algorithms
  • Anti-HIV Agents / administration & dosage
  • Counseling
  • Female
  • HIV Infections / diagnosis*
  • HIV Infections / prevention & control
  • HIV-1*
  • Humans
  • Infectious Disease Transmission, Vertical / prevention & control*
  • Patient Acceptance of Health Care / statistics & numerical data
  • Perinatal Care / methods
  • Pregnancy
  • Pregnancy Complications, Infectious / diagnosis*
  • Referral and Consultation
  • Time Factors

Substances

  • Anti-HIV Agents