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American Public Health Association
133rd Annual Meeting & Exposition
December 10-14, 2005
Philadelphia, PA
APHA 2005
3371.0: Monday, December 12, 2005 - 5:30 PM

Abstract #102502

Prevention of mother-to-child transmission of HIV-1: Performance of rapid HIV-1 tests for high risk women in labor, St. Petersburg and Leningrad Region, Russia, 2004

Aza Rakhmanova, MD, PhD1, Evgeny Voronin, MD, PhD1, Natalia Akatova, MD1, Natalia Khaldeeva, MD, PhD1, Dmitry Kissin, MD, MPH2, M. Kathleen Glynn, DVM, MPVM3, Elena Vinogradova, MD, PhD1, Sergey Kulev1, Denise Jamieson, MD, MPH2, Mida Samarskaya, MD1, Alexei Yakovlev, MD, PhD1, Galina Volkova, MD, PhD1, Elena Stepanova, MD1, William C. Miller, MD, PhD, MPH4, and Susan E. Hillis, PhD, RN2. (1) Elizabeth P. Glaser Foundation Call-To-Action Project, 41 Kirochnaya Street, St. Petersburg, 193015, Russia, (2) NCCDPHP/DRH, Centers for Disease Control and Prevention, 4770 Buford Hwy NE, MS K-34, Atlanta, GA 30341, (770) 488-6408, DKissin@cdc.gov, (3) NCHSTP/DH, Centers for Disease Contorl and Prevention, 1600 Clifton Road, MS-E47, Atlanta, GA 30333, (4) Department of Epidemiology, UNC School of Public Health, CB#7435 McGavran-Greenberg Hall, Chapel Hill, NC 27599-7435

BACKGROUND: The Russian Ministry of Health recommends rapid HIV-1 testing (RT) of all pregnant women presenting for delivery with undocumented HIV serostatus, with parallel standard HIV testing using EIA with Western blot confirmation. METHODS: From April 13 to October 15, 2004, eligible women presenting in active labor at 3 high-risk maternity hospitals in St. Petersburg and Leningrad Region, Russia, were offered point-of-care RT using Determine (Abbott Laboratories) and standard HIV testing. Criteria for RT included injection drug use or no documented HIV test at or after 34 weeks of pregnancy. RESULTS: Of the 5,132 women giving birth at participating hospitals, 2,632 (51.3%) were eligible for RT. Of these, 2,104 (79.9%) underwent RT, and 53 (2.5%) were positive. The median time between blood collection and availability of test results to labor and delivery staff was 20 minutes for RT, compared with 3 days for standard EIA testing. Only 2.5% of standard test results were available to labor and delivery staff before delivery, while 91.1% of point-of-care RT results were available a median of 4.3 hours before delivery. The use of point-of-care RT allowed 38 of 53 (71.7%) presumed HIV-infected women and 49 of 50 (98.0%) infants born alive to these women to receive antiretroviral therapy (ART). CONCLUSIONS: The use of RT improves timely detection of HIV infection among women presenting in labor with undocumented HIV serostatus, and facilitates appropriate delivery of intrapartum ART to these women and their infants, to strengthen the prevention of mother-to-child transmission of HIV.

Learning Objectives:

Keywords: HIV/AIDS, Prevention

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.

[ Recorded presentation ] Recorded presentation

Prevention of Mother-to-Child HIV Transmission

The 133rd Annual Meeting & Exposition (December 10-14, 2005) of APHA