630: Getting to zero: a demonstration project of partner HIV testing in the prenatal setting

Abstract

Although universal antenatal HIV screening identifies most women with HIV, women who are exposed to HIV and seroconvert during pregnancy remain at risk of not being identified. These women are at significantly increased risk of maternal-to-child transmission (MTCT). Implementation of male partner HIV testing in routine prenatal care has not previously been evaluated in the United States. The objective was to assess interest in and uptake of partner HIV testing services as well as characteristics associated with each. This quality improvement demonstration project included all pregnant English-speaking HIV-negative women receiving publicly funded prenatal care in a single hospital-based practice located in a high HIV prevalence urban center. Women were offered free HIV screening for their male sexual partners. From April 2017 to June 2018, enrolled women completed surveys on sociodemographic and medical access characteristics as well as HIV testing history and preferences. Women were invited to bring their partners to a prenatal visit where pre-test counseling was provided and HIV testing offered. Factors associated with pregnant women’s interest in having their partner tested and completion of partner testing were assessed. Of 392 women approached, 70% (N=274) completed study surveys. Although the majority (73%, N=200) of women desired their partner undergo HIV testing, only 18 (7%) of the partners of women who enrolled ultimately completed HIV testing (Figure). Maternal sociodemographic characteristics (age, race/ethnicity, parity, number of current sexual partners, educational, employment, and marital status) were not associated with interest in or completion of partner HIV testing. Similarly, HIV testing history, testing preferences, and medical access characteristics were not significantly associated with interest in or uptake of partner testing services (Table). Male partner HIV testing has the potential for primary HIV prevention and may be especially critical during pregnancy. Although the majority of low income women in an urban prenatal clinic expressed interest in having their partner tested, uptake of the free HIV testing services was uncommon. A focused assessment of implementation barriers is needed to optimize partner testing and eliminate HIV transmission to mothers and their babies.View Large Image Figure ViewerDownload Hi-res image Download (PPT)