American Journal of Obstetrics & Gynecology
Volume 197, Issue 3, Supplement , Pages S83-S89 , September 2007

Approaches for scaling up human immunodeficiency virus testing and counseling in prevention of mother-to-child human immunodeficiency virus transmission settings in resource-limited countries

  • Omotayo O. Bolu, MBBS, MSc

      Affiliations

    • Centers for Disease Control and Prevention, National Center for HIV, Hepatitis, STD, and TB Prevention, Global AIDS Program, Prevention of Mother-to-Child HIV Transmission Team, Atlanta, GA
    • Corresponding Author InformationReprints: Dr Omotayo O. Bolu, Centers for Disease Control and Prevention, National Center for HIV, Hepatitis, STD, and TB Prevention, Global AIDS Program, Prevention of Mother-to-Child HIV Transmission Team, 1600 Clifton Rd, MS E-04, Atlanta, GA 30333.
    • ,
  • Virginia Allread, MPH

      Affiliations

    • Francois-Xavier Bagnoud Center, University of Medicine and Dentistry of New Jersey, Newark, NJ
    • ,
  • Tracy Creek, MD, MPH

      Affiliations

    • Centers for Disease Control and Prevention, National Center for HIV, Hepatitis, STD, and TB Prevention, Global AIDS Program, Prevention of Mother-to-Child HIV Transmission Team, Atlanta, GA
    • ,
  • Elizabeth Stringer, MD, MSc

      Affiliations

    • University of Zambia School of Medicine, Centre for Infectious Disease Research in Zambia, Lusaka, Zambia
    • ,
  • Fatu Forna, MD, MSc

      Affiliations

    • Centers for Disease Control and Prevention, National Center for HIV, Hepatitis, STD, and TB Prevention, Global AIDS Program, Prevention of Mother-to-Child HIV Transmission Team, Atlanta, GA
    • ,
  • Marc Bulterys, MD, PhD

      Affiliations

    • Centers for Disease Control and Prevention, Global AIDS Program, Lusaka, Zambia.
    • ,
  • Nathan Shaffer, MD

      Affiliations

    • Centers for Disease Control and Prevention, National Center for HIV, Hepatitis, STD, and TB Prevention, Global AIDS Program, Prevention of Mother-to-Child HIV Transmission Team, Atlanta, GA

Received 15 December 2006 ,Revised 14 February 2007 ,Accepted 1 March 2007.

References 

  1. UNAIDS. 2006 Report on the global AIDS epidemic. Available at: http://www.unaids.org/en/HIV_data/2006GlobalReport/default.asp. Accessed July 24, 2006.
  2. De Cock KM, Fowler MG, Mercier E, et al. Prevention of mother-to-child HIV transmission in resource-poor countries: translating research into policy and practice. JAMA. 2000;283:1175–1182
  3. Simonon A, Lepage P, Karita E, et al. An assessment of the timing of mother-to-child transmission of human immunodeficiency virus type 1 by means of polymerase chain reaction. J Acquir Immune Defic Syndr. 1994;7:952–957
  4. Bertolli J, St Louis ME, Simonds RJ, et al. Estimating the timing of mother-to-child transmission of human immunodeficiency virus in a breast-feeding population in Kinshasa, Zaire. J Infect Dis. 1996;174:722–726
  5. Mock PA, Shaffer N, Bhadrakom C, et al. Maternal viral load and timing of mother-to-child HIV transmission, Bangkok, Thailand. AIDS. 1999;13:407–414
  6. Dorenbaum A, Cunningham CK, Gelber RD, et al. International PACTG 316 Team Two-dose intrapartum/newborn nevirapine and standard antiretroviral therapy to reduce perinatal HIV transmission: a randomized trial. JAMA. 2002;288:189–198
  7. Cooper ER, Charurat M, Mofenson L, et al. Combination antiretroviral strategies for the treatment of pregnant HIV-1-infected women and prevention of perinatal HIV-1 transmission. J Acquir Immune Defic Syndr. 2002;29:484–494
  8. Centers for Disease Control and Prevention. Reduction in perinatal transmission of HIV infection—United States, 1985-2005. MMWR Morb Mortal Wkly Rep. 2006;55:592–596
  9. Bulterys M. Use of antiretroviral drugs to prevent mother-to-child HIV-1 transmission in high-prevalence, resource-poor settings. In:  Butera ST editors. HIV chemotherapy: a critical review. Norfolk (UK): Caister Academic Press; 2005;p. 159–194
  10. Temmerman M, Quaghebeur A, Mwanyumba F, Mandaliya K. Mother-to-child HIV transmission in resource poor settings: how to improve coverage?. AIDS. 2003;17:1239–1242
  11. Stringer JS, Sinkala M, Maclean CC, et al. Effectiveness of a city-wide program to prevent mother-to-child HIV transmission in Lusaka, Zambia. AIDS. 2005;19:1309–1315
  12. Dabis F, Ekpini ER. HIV-1/AIDS and maternal and child health in Africa. Lancet. 2002;359:2097–2104
  13. Bassett MT. Ensuring a public health impact of programs to reduce HIV transmission from mothers to infants: the place of voluntary counseling and testing. Am J Public Health. 2002;92:347–351
  14. UNAIDS Global Reference Group on HIV/AIDS and Human Rights. UNAIDS/WHO policy statement on HIV testing. Available at: http://www.who.int/hiv/pub/vct/en/hivtestingpolicy04.pdf. Accessed July 24, 2006.
  15. World Health Organization. The Right to Know. New Approaches to HIV Testing and Counseling. Geneva (Switzerland): World Health Organization/HIV2003.08. August 2003. www.searo.who.it/LinkFiles/Prevention_and_control_right_know_94E.pdf
  16. Centers for Disease Control and Prevention. HIV testing among pregnant women—United States and Canada, 1998-2001. MMWR Morb Mortal Wkly Rep. 2002;51:1013–1016
  17. Centers for Disease Control and Prevention. Introduction of routine HIV testing in prenatal care—Botswana, 2004. MMWR Morb Mortal Wkly Rep. 2004;53:1083–1086
  18. Van’t Hoog A, Mbori-Ngacha DA, Marum LH, et al. Preventing mother-to-child transmission of HIV in western Kenya: operational issues. J Acquir Immune Defic Syndr. 2005;40:344–349
  19. Welty T, Bulterys M, Welty ER, et al. Integrating prevention of mother-to-child HIV transmission into routine antenatal care: the key to program expansion in Cameroon. J Acquir Immune Defic Syndr. 2005;40:486–493
  20. Cartoux M, Sombie I, Van de Perre P, Meda N, Tiendrebeogo S, Dabis F. Evaluation of two techniques of HIV pretest counseling for pregnant women in West Africa. Int J STD AIDS. 1999;10:199–201
  21. Rutenberg N, Kalibala S, Baek C, Rosen J. Programme recommendations for the prevention of mother-to-child transmission of HIV: a practical guide for managers. Available at: www.popcouncil.org/pdfs/horizons/pmtctunicefevalprogmgr.pdf. Accessed July 24, 2006.
  22. Downing RG, Otten RA, Marum E, et al. Optimizing the delivery of HIV counseling and testing services: the Uganda experience using rapid HIV antibody test algorithms. J Acquir Immune Defic Syndr. 1998;18:384–388
  23. Malonza IM, Richardson BA, Kreiss JK, Bwayo JJ, Stewart GC. The effect of rapid HIV-1 testing on uptake of perinatal HIV-1 interventions: a randomized clinical trial. AIDS. 2003;17:113–118
  24. Mhazo M, Moyo S, von Lieven A, Maponga C, Bassett MT. HIV counseling and testing amongst antenatal women using lay community volunteers: experience from urban Zimbabwe. In: Presented at the 13th International AIDS Conference, 2000, Durban, South Africa.. 2000;Abstract TuOrC309. July 9-14
  25. Cartoux M, Meda N, Van de Perre P, Newell ML, de Vincenzi I, Dabis F. Acceptability of voluntary HIV testing by pregnant women in developing countries: an international survey. AIDS. 1998;12:2489–2493
  26. Shetty AK, Mhazo M, Moyo S, et al. The feasibility of voluntary counselling and HIV testing for pregnant women using community volunteers in Zimbabwe. Int J STD AIDS. 2005;16:755–759
  27. Chi B, Sinkala M, Stringer E, et al. Employment of off-duty staff: a strategy to meet the human resource needs for a large PMTCT program in Zambia. J Acquir Immune Defic Syndr. 2005;40:381–382
  28. Bulterys M, Fowler MG, Shaffer N, et al. Role of traditional birth attendants in preventing perinatal transmission of HIV. BMJ. 2002;324:222–224
  29. Homsy J, Kalamya JN, Obonyo J, et al. Routine intrapartum HIV counseling and testing for prevention of mother-to-child transmission of HIV in a rural Ugandan hospital. J Acquir Immune Defic Syndr. 2006;42:149–154
  30. Semrau K, Kuhn L, Vwalika C, et al. Women in couples antenatal HIV counseling and testing are not more likely to report adverse social events. AIDS. 2005;19:603–609
  31. Painter T. Voluntary counseling and testing for couples: a high-leverage intervention for HIV/AIDS prevention in sub-Saharan Africa. Soc Sci Med. 2001;53:1397–1411
  32. Perez F, Zvandaziva C, Engelsmann B, Dabis F. Acceptability of routine HIV testing (“opt-out”) in antenatal services in two rural districts of Zimbabwe. J Acquir Immune Defic Syndr. 2006;41:514–520
  33. De Cock KM, Johnson A. From exceptionalism to normalisation: a reappraisal of attitudes and practice around HIV testing. BMJ. 1998;316:290–293
  34. Sherr L, Fox Z, Lipton M, et al. Sustaining HIV testing in pregnancy—evaluation of routine offer of HIV testing in three London hospitals over 2 years. AIDS Care. 2006;18:183–188
  35. Stringer EM, Stringer JS, Cliver SP, Goldenberg RL, Goepfert AR. Evaluation of a new testing policy for human immunodeficiency virus to improve screening rates. Obstet Gynecol. 2001;98:1104–1108
  36. Simpson WM, Johnstone FD, Boyd FM, et al. A randomised controlled trial of different approaches to universal antenatal HIV testing: uptake and acceptability and Annex: antenatal HIV testing—assessment of a routine voluntary approach. Health Technol Assess. 1999;3:1–112
  37. Gerberding JL, Jaffe HW. Dear colleague letter, April 22, 2003. Atlanta, GA: US Department of Health and Human Services, Centers for Disease Control and Prevention. Available at: http://www.cdc.gov/hiv/projects/perinatal/2003/letter.htm. Accessed July 24, 2006.
  38. American College of Obstetricians and Gynecologists. Prenatal and perinatal human immunodeficiency virus testing: expanded recommendations. ACOG Opinion Number 304, Washington (DC): American College of Obstetricians and Gynecologists; 2004;
  39. Centers for Disease Control and Prevention. Revised recommendations for HIV testing of adults, adolescents, and pregnant women in health-care settings. MMWR Morb Mortal Wkly Rep. 2006;55:1–17(RR-14)
  40. Kiarie J, Nduati R, Koigi K, Musia J, John G. HIV-1 testing in pregnancy: acceptability and correlates of return for test results. AIDS. 2000;14:1468–1470
  41. De Cock K, Bunnell R, Mermin J. Unfinished business—expanding HIV testing in developing countries. N Engl J Med. 2006;354:440–442
  42. De Bruyn M, Paxton S. HIV testing of pregnant women—what is needed to protect positive women’s needs and rights?. Sex Health. 2005;2:143–151
  43. World Health Organization. Rapid HIV tests: guidelines for use in HIV testing and counseling services in resource-constrained settings. 2004. Available at: http://whqlibdoc.who.int/publications/2004/9241591811.pdf. Accessed July 24, 2006.
  44. National guidelines. Prevention of mother-to-child transmission (PMTCT) of HIV/AIDS. Garbone, Botswana: Ministry of Health; 2005;
  45. National AIDS Council/Ministry of Health, Zambia. Zambia’s national protocol guidelines. Integration of prevention of mother-to-child transmission of HIV. Lusaka, Zambia: National AIDS Council/Ministry of Health; 2006;
  46. Koblavi DS, Maurice C, Yavo D, et al. Sensitivity and specificity of human immunodeficiency virus rapid serologic assays and testing algorithms in an antenatal clinic in Abidjan, Ivory Coast. J Clin Microsc. 2001;39:1808–1812
  47. Brattegaard K, Kouadio J, Adom ML, Doorly R, George JR, De Cock KM. Rapid and simple screening and supplemental testing for HIV-1 and HIV-2 infections in West Africa. AIDS. 1993;7:883–885
  48. Delaney K, Branson B, Uniyal A, et al. Performance of an oral fluid rapid HIV 1/2 test: experience from four CDC studies. AIDS. 2006;20:1655–1660
  49. Doyle NM, Levison JE, Gardner MO. Rapid HIV versus enzyme-linked immunosorbent assay screening in a low-risk Mexican American population presenting in labor: a cost-effectiveness analysis. Am J Obstet Gynecol. 2005;193:1280–1285
  50. McKenna SL, Muyinda GK, Roth D, et al. Rapid HIV testing and counseling for voluntary testing centers in Africa. AIDS. 1997;11:S103–S110
  51. United Nations Children’s Fund/World Health Organization. Antenatal care in developing countries: promises, achievements, and missed opportunities. An analysis of levels, trends and differentials, 1990-2001, 2003. Available at: http://www.unicef.org/media/files/antenatal.pdf. Accessed July 24 2006.
  52. Viani R, Araneta M, Ruiz-Calderon J, et al. Perinatal HIV counseling and rapid testing in Tijuana, Baja California, Mexico: seroprevalence and correlates of HIV infection. J Acquir Immune Defic Syndr. 2006;41:87–92
  53. Bulterys M, Jamieson DJ, O’Sullivan MJ, et al. Mother-Infant Rapid Intervention At Delivery (MIRIAD) Study Group Rapid HIV-1 testing during labor: a multicenter study. JAMA. 2004;292:219–223
  54. Grobman WA, Garcia PM. The cost-effectiveness of voluntary intrapartum rapid human immunodeficiency virus testing for women without adequate prenatal care. Am J Obstet Gynecol. 1999;181:1062–1071
  55. Yonga I, Savonsnick P, Buono N, Wilfert C. Intrapartum testing at EGPAF sites in Kenya: counseling and testing of women with unknown status at delivery. In: Presented at the 2006 HIV/AIDS Implementers Meeting of the President’s Emergency Plan for AIDS Relief, Durban, South Africa. 2006;Abstract 135
  56. Melvin AJ, Alarcon J, Velasquez C, et al. Rapid HIV type 1 testing of women presenting in late pregnancy with unknown HIV status in Lima, Perú. AIDS Res Hum Retroviruses. 2004;20:1046–1052
  57. Asia Pacific Network of People Living With HIV/AIDS. AIDS discrimination in Asia. 2004. Available at: www.gnpplus.net/regions/asiapac.html Accessed August 2005.
  58. Jamieson DJ, O’Sullivan MJ, Maupin R, et al. The challenges of informed consent for rapid HIV testing in labor. J Womens Health. 2003;12:889–895
  59. Gray RH, Li X, Kigozi G, et al. Increased risk of incident HIV during pregnancy in Rakai, Uganda: a prospective study. Lancet. 2005;366:1182–1188
  60. Soorapanth S, Sansom S, Bulterys M, Besser M, Theron G, Fowler MG. Cost-effectiveness of HIV re-screening during late pregnancy to prevent mother-to-child HIV transmission in South Africa and other resource-limited settings. J Acquir Immune Defic Syndr. 2006;42:213–221
  61. Centers for Disease Control and Prevention/World Health Organization/United Nations Children’s Fund/USAID/Office of The U.S. Global AIDS Coordinator. Testing and counselling for prevention of mother-to-child transmission of HIV (TC for PMTCT) support tools. Available at: http://womenchildrenhiv.org/wchiv?page=vc-10-00#S1X. Accessed July 24, 2006.
  62. Bajunirwe F, Muzoora M. Barriers to the implementation of programs for the prevention of mother-to-child transmission of HIV: a cross-sectional survey in rural and urban Uganda. AIDS Res Ther. 2005;2:10
  63. Farquhar C, Kiarie J, Richardson B, et al. Antenatal couple counseling increases uptake of interventions to prevent HIV-1 transmission. J Acquir Immune Defic Syndr. 2004;37:1620–1626
  64. Abdallah A, Semo B, Justman J, El-Sadar W. Increasing male participation in PMTCT. In: Presented at the 2006 HIV/AIDS Implementers Meeting of the President’s Emergency Plan for AIDS Relief, Durban, South Africa. 2006;Abstract 80
  65. Hallissey M, Shongwe N. Involving Men in a PMTCT-Plus project as a strategy to achieving behavioral change and positive outcomes (pilot operational research and community based project: PMTCT-plus) BMS/STF. In: Presented at the 2006 HIV/AIDS Implementers Meeting of the President’s Emergency Plan for AIDS Relief, Durban, South Africa.. 2006;Abstract 96
  66. USAID/Synergy. Women’s experiences with HIV serodisclosure in Africa: implications for VCT and PMTCT. Meeting Report. Washington (DC): USAID; 2004;

 The findings and views expressed herein are those of the authors and do not necessarily represent the views of the U.S. Centers for Disease Control and Prevention.

PII: S0002-9378(07)00296-7

doi: 10.1016/j.ajog.2007.03.006

American Journal of Obstetrics & Gynecology
Volume 197, Issue 3, Supplement , Pages S83-S89 , September 2007

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