Universal HIV testing during pregnancy: a determinant of early diagnosis of HIV infection
A. Duran, A. Basombrio, M. Nan, S. Vulcano, F. Portnoy, M. Vila
Ministry of Health, Coordinación Sida, Ciudad de Buenos Aires, Argentina
Background: Women's grater use of healthcare service, the standard practice of recommending HIV testing to all pregnant women and monitoring of women having sexual partners with known HIV status are factors that have impacted the epidemiological pattern of HIV infection in Argentina.We analyzed clinical status of female HIV infected population diagnosed during pregnancy and compared with non pregnant women and male population.
Methods: We searched all new cases of HIV infection diagnosed between 2003-2008 and reported to AIDS Program of the Ministry of Health of Buenos Aires. We compared clinical status at time of diagnosis between pregnant women, non pregnant women and male population.
Results: Between 2003 and 2008, 7282 new diagnosis of HIV infection were reported, 38% in women. Male /female rate was 1.64.A 26.25% of women included had at least one delivery during the analyzed period. Diagnosis of HIV infection was made during pregnancy in 45.3% of them.Late diagnosis of HIV was more frequent among men and no pregnant women (table 1)While only 2.5% of women, who gave birth, had AIDS at time of diagnosis, this percent amounted to 20.7% in women without birth and 31.7% in male population.
[Table 1- Clinical status at diagnosis time]
|Clinical status at diagnosis||Women without birth||Women with
birth||Global Female population||Male population|
|Acute retroviral syndrome||36 (1.68%)||13 (1.93%)||49 (1.74%)||81 (1.81%)|
|Asymptomatic||1323 (61.9%)||614 (91.23%)||1937 (68.93%)||2278 (50.94%)|
|Symptomatic but not AIDS||334 (15.6%)||29 (4.3%)||363 (12.9%)||694 (15.5%)|
|AIDS||444 (20.7%)||17 (2.5%)||461 (16.4%)||1419 (31.7%)|
|total||2137 (100%)||673 (100%)||2810 (100%)||4472 (100%)|
Conclusions: In order to improve early diagnosis of HIV infection, offering of voluntary testing should be incorporated to standard of care of clinicians of all disciplines as well as to expand and enhance accessibility to HIV testing sites, particularly for male population.
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