HIV Testing During Childbirth

Ladies, if you have ever endured childbirth, more than likely you know that even while having intense contractions that make you want to punch whoever is within reach at the moment, nurses are coming in every five minutes poking and prodding you and checking this and that. Sure, they mean well, but give a woman some time to practice her Lamaze and focusing techniques, why don’t you? Despite my self-centered thoughts on this poking and prodding (forgive me, my births were pretty recent), they are essential to the health of both mother and baby. One such example stems from research recently done in the sub-Saharan African country of Cameroon. HIV rates are high here and many women who are pregnant have no idea whether or not they may be infected with HIV. This research has demonstrated that doing a rapid HIV test while the mother is in labor could help detect the virus, thus allowing both mother and baby to receive the treatment they need so that mother-to-child transmission is less likely to occur.

The study was performed in Cameroon’s capital, Yaounde, at four different hospitals. Close to 2,500 pregnant women were tested; none of the women knew at the time whether or not they were infected with HIV.  This study was led by Eugene Kongnyuy from the Liverpool School of Tropical Medicine and he collaborated with researchers from the University of Yaounde. Of the women who were approached to test, approximately 88% of them agreed to be tested for HIV during their labor. In addition, the results of these tests showed that the rate of infection in pregnant women who get tested for HIV during their labor is even higher (almost 4 points higher) than the estimates provided in a recent health survey. The percentage captured by the research team was 10.1% compared to the 6.8% highlighted in the health survey. Researchers used this data to impress upon the public that getting tested for HIV during a woman’s labor is vital.

Statistics show that well over three million babies and toddlers are currently infected with HIV; most of these cases occurred due to mother-to-child transmission. Researchers from this study proved to demonstrate that performing rapid HIV testing during a pregnant woman’s labor is, literally, the last chance for treatment to take place to reduce the chance of mother-to-child transmission. The study had no problem demonstrating that doing these rapid HIV tests was a practical step to reduce the mother-to-child transmission rates; however, implementing these tests as a standard across the board would be a daunting task considering many hospitals and clinics do not currently have the resources to do so.

As with many tests that are currently performed on pregnant women in many countries, the researchers in this study suggested that hospitals present “an opt-out approach for HIV testing during labour in Cameroon (i.e. women are informed that HIV testing will be routine during labour if HIV status is unknown but each person may decline to be tested). Such an approach will decrease the proportion of women who give birth with unknown HIV status and increase the number of mother-infant pairs who receive appropriate treatment for preventing MTCT (mother-to-child transmission) of HIV”. They also recommended that hospitals and clinics should evaluate how cost-effective it would be to counsel and test for HIV during labor before the standard gets implemented across the nation.