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Repeat antenatal HIV testing in the third trimester: a study of feasibility and maternal uptake rates
Author(s) -
Williams B,
Costello M,
McHugh E,
Le Prevost M,
PhilEbosie A,
Tilsed C,
McSorley J,
Murphy S,
Brook G,
Williams A
Publication year - 2014
Publication title -
hiv medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.53
H-Index - 79
eISSN - 1468-1293
pISSN - 1464-2662
DOI - 10.1111/hiv.12110
Subject(s) - medicine , third trimester , obstetrics , pregnancy , human immunodeficiency virus (hiv) , workload , test (biology) , family medicine , first trimester , seroconversion , gestation , gynecology , paleontology , genetics , computer science , biology , operating system
Objectives The study aimed to assess the feasibility and acceptability of third‐trimester antenatal HIV testing within our service after two cases of HIV seroconversion in pregnancy were noted in 2008. N orth A merican G uidelines recommend universal third‐trimester HIV testing in areas with an HIV prevalence of more than 1 per 1000. The HIV prevalence rate in our area is 3.01 per 1000. Methods Pregnant women prior to 28 weeks of gestation were recruited at booking between 1 S eptember 2008 and 31 A ugust 2009 and offered an additional third‐trimester HIV test. Consent was obtained and testing was performed by hospital and community midwives. Information was entered into a modified existing electronic maternity database. A qualitative e‐mail survey of midwives investigated barriers to participation in the study. Results A total of 4134 women delivered; three (< 0.1%) declined first‐trimester testing. Twenty‐two women (0.5%) tested HIV positive, of whom six were newly diagnosed. Overall, 2934 of 4134 women (71%) were offered and accepted a third‐trimester HIV test and had results available. Data were unavailable for 195 women (4.7%). A total of 663 of 4131 women (16%) were not offered a third‐trimester test. Of 3273 women documented as having been offered a test, 3177 (97.1%) accepted. There were no positive third‐trimester tests. Forty of 50 (80%) midwives surveyed responded with questionnaire feedback and cited lack of national policy and extra workload as barriers to performing third‐trimester testing. Conclusions Third‐trimester testing was feasible and consent rates were high in those offered repeat testing. Third‐trimester testing has the potential to prevent paediatric HIV infection and universal testing should be considered in high‐prevalence areas.