Division of HIV/STI Epidemiology, Evaluation, and Partner Services, New York State Department of Health, Albany, New York, USA.
Division of HIV and Hepatitis Health care, New York State Department of Health, AIDS Institute, Albany, New York, USA.
J Womens Health (Larchmt). 2024 Sep;33(9):1240-1247. doi: 10.1089/jwh.2023.0835. Epub 2024 Jun 12.
New York State Department of Health (NYSDOH) recommends that all pregnant patients receive human immunodeficiency virus (HIV) screening during pregnancy. This study assessed the prevalence of repeat prenatal HIV testing and factors associated with receipt of the recommended tests. Data from the NYSDOH newborn screening program were used to randomly select pregnant persons without HIV who delivered a liveborn infant in 2017. Receipt of repeat testing was defined as an initial HIV test in the first or second trimesters and the final in the third trimester (relaxed); or an initial test in the first trimester and the final in the third trimester (strict). Relative risks (RRs) and 95% confidence intervals were calculated in bivariate analyses. Adjusted RRs were calculated to determine associations between demographic and clinical factors and receipt of repeat HIV testing. The cohort included 2,225 individuals. Roughly one quarter (24%) received the recommended tests in the first or second and third trimesters and 17% received them in the first and third trimesters. Individuals who reported Hispanic or Asian race/ethnicities, had government-funded insurance, started prenatal care in the first trimester, delivered in New York City, or received prenatal hepatitis C virus screening were significantly more likely to receive repeat testing using either definition. Despite the benefits and cost-effectiveness, the prevalence of repeat prenatal HIV screening during the third trimester remains persistently low. Improved messaging and targeted education and resources to assist prenatal providers could reinforce the importance of repeat testing and reduce residual perinatal HIV transmission.
纽约州卫生部（NYSDOH）建议所有孕妇在怀孕期间接受艾滋病毒（HIV）筛查。本研究评估了重复产前 HIV 检测的流行率以及与接受推荐检测相关的因素。利用纽约州卫生部新生儿筛查计划的数据，随机选择了 2017 年分娩活产婴儿且未感染 HIV 的孕妇。重复检测是指在第一或第二孕期进行初始 HIV 检测，在第三孕期进行最终检测（宽松）；或在第一孕期进行初始检测，在第三孕期进行最终检测（严格）。在双变量分析中计算相对风险（RR）和 95%置信区间。计算调整后的 RR，以确定人口统计学和临床因素与重复 HIV 检测之间的关联。该队列包括 2225 人。大约四分之一（24%）的人在第一或第二和第三孕期接受了推荐的检测，17%的人在第一和第三孕期接受了检测。报告西班牙裔或亚裔种族/民族、有政府资助保险、在第一孕期开始产前护理、在纽约市分娩或接受产前丙型肝炎病毒筛查的人，根据两种定义，接受重复检测的可能性显著更高。尽管有收益和成本效益，但在第三孕期重复进行产前 HIV 筛查的流行率仍然持续较低。改进信息传递以及针对产前提供者的有针对性的教育和资源，可强化重复检测的重要性，并减少残余围产期 HIV 传播。
