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Clinical outcomes of routine opt‐out antenatal human immunodeficiency virus screening: a systematic review
Author(s) -
Ibekwe Everistus,
Haigh Carol,
Duncan Fiona,
Fatoye Francis
Publication year - 2017
Publication title -
journal of clinical nursing
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.94
H-Index - 102
eISSN - 1365-2702
pISSN - 0962-1067
DOI - 10.1111/jocn.13475
Subject(s) - cinahl , medicine , medline , human immunodeficiency virus (hiv) , family medicine , psychological intervention , nursing , political science , law
Aims and objectives To evaluate the clinical outcome of routine screening of human immunodeficiency virus in antenatal clinic settings. Background Despite the growing advances in human immunodeficiency virus management, nearly 30% of the estimated 1·5 million seropositive pregnant women are undiagnosed. Routine opt‐out testing is a strategy endorsed by the World Health Organization in [, 2007] to increase testing rates in clinical settings. Design A systematic review of relevant published literature. Methods A comprehensive electronic search for relevant studies in Science Direct, MEDLINE, SCOPUS, CINAHL and PubMed was conducted with search terms (Box 2). Hand searches were also conducted for additional resources. There were no geographical restrictions. Searches were restricted to English language and studies conducted between 1998–2015; totaling 1097 were retrieved and carefully appraised for review. Eighteen studies were eligible for review: eight from Africa, five from the United States, three from Europe, one from Australia and one from Asia. Results Fourteen studies reported increases in human immunodeficiency virus testing rate. Following the introduction of routine testing, human immunodeficiency virus testing rates increased from values ranging from 68–99·9% with median value of 88%. The comparison studies reported testing uptake of 22–93·5% with median value of 59%. Maternal human immunodeficiency virus case detection rates nearly doubled following adoption of routine testing at values of 99 and 45% during opt‐in. Linkage to treatment and care for prevention of vertical transmission was reported on six studies, and results ranged between 12·9–77·2%. Conclusion The findings show that irrespective of human immunodeficiency virus epidemiological scenarios, routine testing gave more women opportunity to learn their human immunodeficiency virus status and take measures for prevention of mother‐to‐child transmission of human immunodeficiency virus. Future studies should focus on identifying strategies to improving linkages to treatment and care for prevention of vertical transmission. Relevance to clinical practice Understanding the contributions of Routine opt‐out testing in antenatal clinic would help practitioners adopt the novel testing model for more mothers to learn their human immunodeficiency virus status for prevention of mother‐to‐child transmission.