Malonza Isaac M, Richardson Barbra A, Kreiss Joan K, Bwayo Job J, Stewart Grace C
Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland.
AIDS. 2003 Jan 3;17(1):113-8. doi: 10.1097/00002030-200301030-00015.
We examined whether HIV-1 testing using a rapid assay increases the proportion of pregnant women obtaining HIV-1 results and the uptake of perinatal HIV-1 interventions.
Pregnant women attending public health clinics in Nairobi were offered voluntary counselling and testing for HIV-1. Consenting women were randomly assigned to receive either rapid or conventional HIV-1 testing. Women randomly assigned to rapid testing were allowed to receive same-day results or to return later. The results for women randomly assigned to conventional enzyme-linked immunosorbent assay (ELISA) testing were available after 7 days. HIV-1-infected women were referred for antiretroviral prophylaxis to prevent mother-to-child transmission of HIV-1.
Among 1282 women offered voluntary HIV-1 testing and counselling, 1249 accepted testing, of whom 627 were randomly assigned to rapid testing and 622 to conventional testing. The median duration between testing and obtaining results was 0 days for women who received rapid testing compared with 11 days for women who received conventional testing. The percentage receiving HIV-1 results was significantly higher among women who received rapid testing compared with conventional testing. Of 161 HIV-1-seropositive women, only 24 received antiretroviral prophylaxis. The uptake of perinatal HIV-1 interventions did not differ between HIV-1-seropositive women randomly assigned to rapid testing or conventional ELISA testing.
Rapid HIV-1 testing significantly increased the proportion of women receiving HIV-1 results, which is important for sexual and perinatal HIV-1 prevention. The challenge remains to improve the uptake of perinatal HIV-1 interventions among HIV-1-seropositive women.
我们研究了使用快速检测法进行HIV-1检测是否会提高获得HIV-1检测结果的孕妇比例以及围产期HIV-1干预措施的接受率。
在内罗毕的公共卫生诊所就诊的孕妇可接受HIV-1的自愿咨询和检测。同意检测的妇女被随机分配接受快速或传统的HIV-1检测。被随机分配接受快速检测的妇女可以当天拿到结果，也可以稍后再来取。被随机分配接受传统酶联免疫吸附测定（ELISA）检测的妇女在7天后可拿到结果。感染HIV-1的妇女会被转介接受抗逆转录病毒药物预防，以防止HIV-1母婴传播。
在1282名接受HIV-1自愿检测和咨询的妇女中，1249人接受了检测，其中627人被随机分配接受快速检测，622人接受传统检测。接受快速检测的妇女从检测到拿到结果的中位时间为0天，而接受传统检测的妇女为11天。与传统检测相比，接受快速检测的妇女获得HIV-1检测结果的百分比显著更高。在161名HIV-1血清学阳性的妇女中，只有24人接受了抗逆转录病毒药物预防。被随机分配接受快速检测或传统ELISA检测的HIV-1血清学阳性妇女在围产期HIV-1干预措施的接受率上没有差异。
快速HIV-1检测显著提高了获得HIV-1检测结果的妇女比例，这对性传播和围产期HIV-1预防很重要。提高HIV-1血清学阳性妇女围产期HIV-1干预措施的接受率仍然是一项挑战。
