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One Test. Two Lives. HIV Screening for Prenatal Care

CDC's One Test. Two Lives. program gives healthcare providers tools to test pregnant women for HIV infection and help reduce the number of infants born with HIV. One Test. Two Lives. is a part of the CDC Act Against AIDS campaign.

Photo: A preganant woman and healthcare professional CDC recommends HIV screening for all women as a standard part of prenatal care in order to identify and treat HIV and to prevent transmission of HIV to infants. Women who test positive for HIV and begin treatment early in their pregnancy reduce the risk of mother- to- child HIV transmission to 2% or less. CDC's One Test. Two Lives. campaign gives obstetricians, nurse-midwives, and other providers tools to ensure that all their patients have the opportunity to learn their HIV status as a routine part of prenatal care and to protect their newborns from HIV infection. Kevin Ault, MD, Associate Professor of Gynecology and Obstetrics at Emory University's School of Medicine and a consultant to the campaign, commented, "All pregnant women want the best for their children, and routine prenatal HIV testing is part of that".

The decrease in pediatric AIDS diagnoses can be attributed to routine screening and the use of antiretroviral medications. However, mother-to-child HIV transmission continues in the United States, in part because many pregnant women still are not being tested. Studies suggest that 26 percent of mothers who gave birth to HIV-infected infants were unaware of their infection prior to labor and delivery in 2007.

Campaign Uses Simple Messages to Encourage Prenatal HIV Screening

One Test. Two Lives. emphasizes three points:

Pregnant women are likely to get tested if their providers strongly recommend it. In a study of 1,362 pregnant women, 93 percent of women who felt their providers strongly recommended an HIV test decided to get tested.
Screening for HIV early in pregnancy, preferably at the first obstetrical visit, benefits both mothers and babies. Women with HIV who start treatment early and maintain it throughout their pregnancy protect their own health and rarely pass HIV to their infants. Women who have not been tested or have increased risk for HIV should be tested in the third trimester.
It is never too late for pregnant women to get tested. Rapid HIV tests allow women who arrive at delivery rooms with unknown HIV status to receive an HIV test. Preventive medications administered to the mother during labor, and to the infant after birth, can reduce the risk of mother-to-child HIV transmission to about 10 percent. Some clinicians may also test a pregnant patient late in the third trimester of pregnancy.

Program Provides Tools to Overcome Barriers to Prenatal HIV Screening

One Test. Two Lives. offers a range of provider materials to help facilitate screening in prenatal settings such as CDC's guide to using an opt-out approach to HIV screening and a tip sheet for talking to patients about HIV screening. A patient brochure, a fact sheet on recommended prenatal tests, and a display poster for medical offices are also available to ensure that patients are aware of the facts and benefits of HIV screening.

Free materials are available on the campaign Web site: www.cdc.gov/1test2lives or by calling CDC INFO at 1-800-CDCINFO (1-800-232-4636).

"This is another opportunity to carry out our mission to protect women's and children's health, put prevention first, and decrease the impact of HIV/AIDS in newborns. These additional resources will help clinicians talk to their pregnant patients about important tests for a healthy pregnancy," noted Yvonne Green, Director of the Office of Women's Health at CDC and a consultant to One Test. Two Lives.