Pregnant Women HIV Testing in Managua: The road to Elimination of Mother-to-Child Transmission

Background: The Pan American Health Organization's (PAHO) goal to eliminate mother-to-child transmission of HIV by 2015 calls for HIV testing rates among pregnant women greater than 95%. Feminization of the Nicaraguan HIV epidemic highlights HIV testing in pregnancy as a first step in prevention of mother-to-child transmission. Data regarding HIV testing rates in pregnant women within Managua are not published. We characterize this for a single Managua health district (District 6.1). Methods: A retrospective epidemiological review of aggregate data from the Managua public health department assessed HIV testing rates among pregnant women in District 6.1 and citywide from January 2010 – December 2011. Results: In Managua, 41.30% of 18,922 pregnant women attending prenatal clinic visits at health centers in 2010 received an HIV test. Twenty-seven pregnant women in Managua were found to be HIV positive, 0.17% of those who were tested. Comparisons between 2010 and 2011 in District 6.1 reflect an increase in women who received an HIV test from 24.23% in 2010 to 49.31% in 2011. This increase was statistically significant (p < 0.001) and has a moderate effect size (phi = 0.26). Two pregnant women were HIV positive in 2010 and three in 2011 in District 6.1. This indicates 0.32% and 0.13% of pregnant women tested in 2010 and 2011, respectively, were HIV positive. Conclusions: HIV testing rates from 2010 to 2011 improved in pregnant women yet remain below PAHO's goal. Therefore interventions are needed across Managua to increase the HIV testing rates of pregnant women.