Rapid intrapartum or postpartum HIV testing at a midwife obstetric unit and a district hospital in South Africa

Int J Gynaecol Obstet. 2011 Apr;113(1):44-9. doi: 10.1016/j.ijgo.2010.10.011. Epub 2011 Jan 19.


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.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Anti-HIV Agents / therapeutic use
  • Cluster Analysis
  • Feasibility Studies
  • Female
  • HIV Infections / complications
  • HIV Infections / diagnosis*
  • HIV Infections / drug therapy
  • HIV Seropositivity
  • Hospitals, District
  • Humans
  • Mass Screening / methods*
  • Midwifery
  • Nevirapine / therapeutic use
  • Patient Acceptance of Health Care
  • Postpartum Period
  • Pregnancy
  • Pregnancy Complications, Infectious / diagnosis*
  • Pregnancy Complications, Infectious / drug therapy
  • Prospective Studies
  • South Africa
  • Time Factors
  • Young Adult


  • Anti-HIV Agents
  • Nevirapine