Amsterdam 2015
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| Abstract #2257 - Women and Sex | ||||
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Session: 56.1: Women and Sex (Oral poster discussion) on Friday @ 12.30-13.30 in Poster room 2 Chaired by Brian Kelly, Wendee Wechsberg Authors: Presenting Author: Dr Ashraf Grimwood - KhethImpilo, South Africa |
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| Additional Authors: | ||||
| Aim: The risk of HIV acquisition amongst women is greater during pregnancy. HIV acquisition during pregnancy is an important contributor to mother-to-child transmission of HIV in sub-Saharan Africa. This study evaluated HIV incidence amongst HIV-negative pregnant women who received a clinic-linked home-based HIV prevention and testing intervention in South Africa. | ||||
| Method / Issue: HIV-negative pregnant women who attended a primary healthcare clinic in a high HIV-prevalence district were included. Women, their partners and women’s household members received HIV prevention education and home-based HIV testing at regular intervals during pregnancy by clinic-linked lay community-based workers. Tests were quality assured, and lay workers were overseen by a professional nurse. Community workers also performed health promotion activities and screening for tuberculosis. The proportion of women who tested HIV positive antenatally amongst women who received at least one repeat HIV test was calculated. | ||||
| Results / Comments: Six hundred and eighty-seven pregnant women booked antenatally, of whom 511 (74%) were HIV-negative. Amongst these women, 426 (83%) received at least one repeat antenatal HIV test. 37% of male partners were tested for HIV, and 33% were referred for HIV testing. Seven women (1.6%) tested HIV positive at repeat testing, a median of 12 weeks (IQR: 9-18 weeks) after the initial HIV test. Amongst women who tested positive at a repeat test, 43% first presented to facilities between 21-26 weeks of gestation, and 57% were diagnosed HIV positive between 27-32 weeks of gestation. | ||||
| Discussion: The incidence of HIV was almost 50% lower in this program compared to the 3% incidence of HIV during pregnancy found in a previous multicentre observational study in South Africa. Home-based HIV education and testing by community workers shows promise in reducing pregnancy-associated HIV acquisition, which may in turn also reduce mother-to-child transmission of HIV. | ||||
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