A rapid HIV testing program for labor and delivery in an inner-city teaching hospital

Although perinatal HIV prophylaxis is probably the most successful HIV prevention intervention to date, between 280 and 370 HIV-positive infants are born in the United States each year. A major reason for continuing vertical transmission is that some HIV-infected women are not aware of their positive HIV serostatus before delivery. A rapid HIV testing program was developed and implemented in a labor and delivery suite at an inner-city teaching hospital in a nonresearch setting. Between April 2002 and June 2005, 259 rapid HIV tests were performed. For the first 19 months of the study, the expedited enzyme-linked immunosorbent assay (ELISA) was performed in 62 patients. For the remainder of the study, the OraQuick rapid HIV-1 antibody test was performed in 197 patients. Turnaround times for the ELISA and OraQuick test were 262 minutes and 143 minutes, respectively, a significant difference (P = .002). Four women had positive test results. Voluntary rapid HIV testing is a feasible strategy for detection of HIV seropositivity in pregnant patients who present in a labor and delivery suite with unknown serostatus. This provides an opportunity to administer antiretroviral prophylaxis and to incorporate other obstetric interventions to decrease vertical HIV transmission.