Rapid HIV screening for women in labor

Abstract

Women now comprise approximately half of all HIV-infected individuals and the epidemic of pediatric HIV disease continues unabated in the developing world. The issue of mother-to-child transmission has been a major concern for public health officials since the early years of this epidemic. Not uncommonly, the first opportunity to ascertain the HIV status is when a woman presents to a hospital in labor. Rapid HIV tests can provide fast results, allowing time for the provider to offer antiretroviral therapy. Several effective antiretroviral regimens are now available for the intrapartum patient whose rapid HIV test comes back as positive. Antiretroviral therapy should be initiated as soon as possible after a positive rapid HIV test result and prior to standard confirmatory testing. This article summarizes the epidemiology of HIV and focuses on testing policies, technologies for rapid screening for HIV infection and antiretroviral regimens that can reduce the risk of perinatal transmission from the intrapartum patient whose rapid HIV test comes back positive.