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133rd Annual Meeting & Exposition
December 10-14, 2005
Mardge Cohen, MD1, Ann E. Bryant, MD, MSc2, Yolanda Olszewski, MPH, MS1, Anne Statton3, and Patricia Garcia, MD, MPH2. (1) Cook County Bureau of Health Services, 2020 W. Harrison Street, Chicago, IL 60612, 312-572-4551, firstname.lastname@example.org, (2) Department of Obstetrics and Gynecology/Maternal-Fetal Medicine, Northwestern University, 333 East Superior St. Suite 410, Chicago, IL 60611, (3) Pediatric AIDS Chicago Prevention Initiative, 2300 Children's Plaza, Box 154, Chicago, IL 60614
Background: In late 2003, the Illinois Perinatal HIV Prevention Act mandated HIV testing in the labor and delivery (L&D) setting for all women (opt-in) and infants (opt-out) with an undocumented HIV status. Using evidence on rapid testing in labor and delivery from the Mother Infant Rapid Testing at Delivery Study, we designed the Perinatal Rapid Testing Implementation in Illinois program (PRTII).
Methods: With support of the Illinois Department of Public Health, each hospital CEO / Obstetric / Laboratory director received a PRTII explanatory resource packet outlining rapid HIV testing implementation. Ten regional perinatal network trainings reached nurse managers from every Illinois hospital. Regional coordinators made 1-5 visits to assist implementation/training in each birthing hospital, providing standardized training sessions, resource binders with counseling script, model policies and consents, an implementation manual and self-directed training materials.
Results: Nurse managers from all 133 Illinois hospitals received regional trainings and resource binders in August 2004; by February 2004, 126 (95%) hospitals completed Key Player Implementation meetings, 81 (61%) completed staff trainings and 59 (44%) began L&D rapid testing. While laboratories will process rapid tests in 80% of hospitals, point-of-care testing will be conducted in 20%. Obstacles to implementing rapid testing included: assuring buy-in from all hospital departments, laboratory approval of point-of-care testing, availability of prenatal records to ascertain HIV serostatus, staff discomfort over counseling, test performance and treatment of preliminary positives.
Conclusions: Utilizing designated staff for hospital-specific training and implementation assistance can fast track statewide implementation of rapid testing in labor and delivery settings.
Keywords: HIV/AIDS, Perinatal Outcomes
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.
The 133rd Annual Meeting & Exposition (December 10-14, 2005) of APHA