Acceptability of perinatal rapid point-of-care HIV testing in an area of low HIV prevalence in the UK

Suzy HM Stokes ¹, Paddy McMaster ^1* and Khaled MK Ismail ²

¹ University Hospital of North Staffordshire, United Kingdom
² Academic Unit of Obstetrics and Gynaecology, Keele University Medical School, United Kingdom

^* To whom correspondence should be addressed. E-mail: paddy.mcmaster{at}uhns.nhs.uk.

Accepted 2 February 2007

Abstract

Objective: To determine the uptake of current antenatal HIV testing, the prevalence of risk factors for HIV in pregnant women and the acceptability of the Rapid Point-of-Care HIV Test (RPOCT) amongst pregnant women and their midwives.

Design: A retrospective review of 717 notes to determine current HIV screening practices and a cross- sectional survey using a self-completed questionnaire for pregnant women and midwives.

Setting: The Antenatal Clinic (ANC) and Postnatal wards (PNW) at a University teaching hospital in the West Midlands.

Participants: 486 women attending the ANC or admitted to the PNW during a fortnight in May-June 2006 and 72 midwives on the delivery ward completed a second questionnaire.

Results: From the questionnaire, it was determined that 90.4% of those offered the standard HIV test accepted it, with 7.2% having at least 1 risk factor for HIV. Of the decliners, over half perceived themselves not at risk. 85.2% would accept the rapid test, including 35.6% of those who declined the standard test. Of midwives questioned, 92.8% agreed/strongly agreed that there is a role for the RPOCT on the delivery ward and 97.2% would be happy to offer the test with appropriate training and guidance.

Conclusions: There is a favourable response to the RPOCT as midwives deem it appropriate for a variety of perinatal settings. Most importantly, it is acceptable to a clinically significant proportion of those who decline the standard test (21 of 59) and therefore has the potential to increase screening and detection rates. Hence, allowing for early diagnosis and the initiation of antenatal interventions, which could reduce the rate of mother-to-child transmission (MTCT) in the UK.

Keywords: HIV in pregnancy, antenatal screening, mother-to-child transmission, rapid HIV test

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