Perinatal HIV testing and diagnosis in Illinois after implementation of the Perinatal Rapid Testing Initiative

Sustainability of Statewide Rapid HIV Testing in Labor and Delivery

“…Combining the rapid testing true positive results (N = 23) with previously known HIV positive women (N = 475), the cumulative estimated HIV seroprevalence among Illinois pregnant women was 0.08%. Of the 498 pregnant women presenting for delivery who were known to be or found to be HIV positive in this time period, 4.62% were identified via rapid testing upon delivery admission, a decline from the 9.88% identified by rapid testing in the 2006–2011 period [23].…”

“…This is a retrospective, population-based analysis of Illinois births reported to PACPI from 2012 to 2015. Data from the 2005–2011 period, prior to the end of PRTII, have been reported by our group previously [23]. For this analysis, data were collected from Illinois hospitals using the closed system and feedback loop described above.…”

“…Providers and hospitals initially failed to achieve testing goals, and thus, in 2004, the Illinois Department of Public Health (IDPH) funded the Perinatal Rapid Testing Implementation in Illinois (PRTII) initiative, a joint effort between multiple collaborating institutions and task forces [22]. PRTII operationalized the legal mandate for testing by providing local resources to hospitals and providers [22, 23]. In 2006, an amendment to the Illinois Perinatal HIV Prevention Act mandated funding and use of a perinatal HIV hotline to report positive rapid tests, performance of neonatal testing if maternal HIV status was unknown, and development of a hospital reporting system for monthly aggregate statistics [24].…”

“…In 2006, an amendment to the Illinois Perinatal HIV Prevention Act mandated funding and use of a perinatal HIV hotline to report positive rapid tests, performance of neonatal testing if maternal HIV status was unknown, and development of a hospital reporting system for monthly aggregate statistics [24]. Subsequent to the initiation of PRTII, our group demonstrated that rapid testing metrics improved dramatically, with over 95% of women presenting with a known HIV status and a decline in the number of neonates discharged with an unknown HIV status [23].…”

Stakeholder Insights from Zika Virus Infections in Houston, Texas, USA, 2016–2017

“…As one maternal fetal medicine specialist explained, “This is a pretty specialized area that’s rapidly evolving, and it’s probably good to send patients for at least a discussion with folks that really have their fingertips on what did we learn last night at midnight when The New England Journal [of Medicine] was released.” Several specialty centers were offered as corollaries, including existing models for perinatal HIV infection, congenital cytomegalovirus infection, or newborn screening for genetic conditions, as well as the designation of 3 tiers of health centers in the 2015 domestic Ebola response ( 15 ). For example, Illinois’s Perinatal Rapid Testing Implementation Initiative for HIV successfully reduced the number of mother–infant pairs who were discharged with unknown HIV status; the initiative created 4 regional networks, a 24-hour hotline, a surveillance system, and implementation resources including template policies and consent forms ( 16 ).…”