Grupo Hospitalar Conceiçao, Porto Alegre, Brazil.
Sex Transm Dis. 2013 Sep;40(9):704-9. doi: 10.1097/01.OLQ.0000430799.69098.c6.
Women in Brazil are routinely tested for HIV-1 during pregnancy with rapid testing repeated during labor in some settings. Partner testing is not routinely offered. The peripartum period provides opportunity for HIV testing of couples.
A cross-sectional study was conducted in a large public hospital in southern Brazil. HIV rapid testing was offered to all pregnant women in labor. Male partners of women who consented to partner inclusion were offered testing. Within HIV-serodiscordant couples, HIV-negative individuals were evaluated for the delta-32 base-pair CCR5 deletion allele.
From February to September 2009, 2888 women delivered, with 1729 eligible women approached for study participation; 1648 (95%) HIV-negative women consented to partner testing and 66% of partners accepted testing. Seven HIV-infected men (0.6%) with no prior diagnosis were identified. Testing strategies uncovered 7 additional serodiscordant couples, 4 HIV-infected women diagnosed at delivery, and 3 HIV-infected men who had not disclosed their status to their partners, for a total serodiscordance rate of 1.3% in 1101 couples. No cases of acute maternal or infant infection were noted. No delta-32 base-pair deletions were identified in 14 HIV-negative partners in serodiscordant relationships. Parameters associated with increased acceptance of partner testing included higher income (P = 0.003), education (P < 0.0001), stable relationships of longer duration (P = 0.001), and female support of partner testing (P < 0.0001).
Testing of couples at the time of labor and delivery is a feasible public health strategy in areas of moderate-to-high HIV prevalence, which can potentially prevent acute infections in men, women, and infants.
在巴西，女性在怀孕期间通常会接受 HIV-1 快速检测，在某些情况下，这种检测会在分娩期间重复进行。但伴侣检测并未常规提供。围产期为夫妇提供了 HIV 检测的机会。
在巴西南部的一家大型公立医院进行了一项横断面研究。对所有分娩中的孕妇进行 HIV 快速检测。同意纳入伴侣的女性的男性伴侣也会接受检测。在 HIV 血清不一致的夫妇中，对 HIV 阴性个体进行 delta-32 碱基对 CCR5 缺失等位基因的评估。
2009 年 2 月至 9 月，共有 2888 名妇女分娩，有 1729 名符合条件的妇女接受了研究参与的邀请；1648 名（95%）HIV 阴性妇女同意进行伴侣检测，其中 66%的伴侣接受了检测。发现了 7 名之前未被诊断出患有 HIV 的男性感染者（0.6%）。检测策略发现了另外 7 对血清不一致的夫妇，其中 4 名妇女在分娩时被诊断为 HIV 感染，3 名未向伴侣透露其状况的 HIV 感染男性，在 1101 对夫妇中，血清不一致率为 1.3%。未发现急性母婴或婴儿感染病例。在血清不一致的关系中，14 名 HIV 阴性伴侣未发现 delta-32 碱基对缺失。伴侣检测接受率较高的相关参数包括较高的收入（P = 0.003）、教育程度（P < 0.0001）、关系稳定且持续时间较长（P = 0.001）和女性支持伴侣检测（P < 0.0001）。
在中等至高 HIV 流行地区，在分娩时对夫妇进行检测是一种可行的公共卫生策略，可潜在预防男性、女性和婴儿的急性感染。
