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A state program for postpartum HIV counseling and testing

S Holman1, M D Sorin, J Crossette

  • 1New York State Department of Health's, AIDS Institute, NY 10001.

Public Health Reports (Washington, D.C. : 1974)
|July 1, 1994
PubMed
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New York

Area of Science:

  • Public Health
  • Infectious Disease Epidemiology
  • Maternal Health

Background:

  • The New York State Department of Health launched an initiative in 1989 to increase human immunodeficiency virus (HIV) counseling and testing for postpartum women.
  • The program aimed to integrate HIV services within the postpartum setting across 24 participating hospitals statewide.
  • Voluntary participation and cooperative arrangements for patient referrals to medical and social services were key components.

Purpose of the Study:

  • To evaluate the effectiveness of the Obstetrical HIV Counseling/Testing/Care Initiative in identifying HIV-positive childbearing women.
  • To assess the rates of HIV testing uptake, return for results, and overall identification of HIV-positive mothers.
  • To identify challenges and variations in hospital performance within the initiative.

Related Experiment Videos

Main Methods:

  • The initiative involved counseling 16,436 at-risk women in the postpartum setting across 24 hospitals between August 1990 and March 1992.
  • HIV testing was offered, with 41.1% consenting, and 44.5% of those tested returned for results and post-test counseling.
  • Data on identified HIV-positive women were collected and combined with other seropositivity data to estimate overall identification rates.

Main Results:

  • Of 16,436 counseled women, 6,754 underwent HIV testing, and 3,000 returned for results.
  • The initiative identified 16% of HIV-positive women giving birth and 22% of previously unidentified seropositive women.
  • An estimated 43.3% of HIV-positive women delivering infants at participating hospitals were identified through voluntary testing.

Conclusions:

  • The Obstetrical HIV Counseling/Testing/Care Initiative identified a significant number of HIV-positive childbearing women, but overall identification rates were suboptimal.
  • Resource limitations, including administrative support and clinical space, posed major implementation obstacles.
  • Variability in hospital performance necessitates further study to improve identification and follow-up rates for HIV-positive mothers and infants.