"The CDC recommends that all hospitals adopt a policy of routine, rapid HIV testing using the opt-out approach for women who have an undocumented HIV test result when presenting to labor and delivery."
The USF Center for HIV Education and Research, central office of the Florida/Caribbean AETC, operates the "Perinatal HIV Transmission Prevention Program”. Funded by the Florida Department of Health, the mission of the project is to provide education and training to Florida health care professionals on the prevention and treatment of HIV transmission between mother and child.
In 2004-2005, the project expanded its scope by focusing on the implementation of rapid testing in labor and delivery settings. Resources have been developed to facilitate the process. Available resources include:
A Florida specific protocol for rapid testing implementation based on the CDC’s model protocol and on the findings of the Mother-Infant Rapid Intervention at Delivery (MIRIAD) study.
Sample policies and procedures that can be adapted to meet hospital requirements.
Patient and provider educational materials.
Assessment and evaluation tools to assist with establishing a baseline for on-going quality assessment of the rapid testing process.
The AETC provides training and technical assistance to labor and delivery staff on methods of implementation. Hospitals are mentored as they initiate and maintain rapid testing.
As the project expands, the focus remains on several key issues. It is important to obtain buy-in from key stakeholders such as hospital administrators and directors, hospital pharmacy personnel, laboratory personnel, labor and delivery staff, Title IV, Medicaid, Medical Associations and other key groups. It is also important to educate prenatal care providers on the importance of transferring patient records that indicate HIV status to labor and delivery in a timely manner. This assists labor and delivery staff in making informed decisions about rapid testing. Appropriate systems are taught for follow-up with women who test positive in labor and delivery.
Rapid Testing Resources:
Florida Hospitals interested in implementing rapid testing should contact:
HIV Rapid Test Training Program
The HIV Rapid Test Training Package is organized into 16 modules and has multiple components including a training video/DVD, presentations slides, trainer's guide, participant's manual and laminated job aides. All the training package materials provide flexibility for adapting to meet specific country requirements. http://www.phppo.cdc.gov/dls/ila/hivtraining/default.aspx
OTHER RESOURCES
ACTS (Assess, Consent, Test, Support) Materials
The Adolescent AIDS Program at Montefiore Medical Center in the Bronx, in collaboration with the New York/New Jersey AIDS Education and Training Center, has developed ACTS (Assess, Counsel, Test, Support), a paradigm-shifting approach to HIV Counseling and Testing (C&T) that is proven to help make C&T a more routine part of health care services in various health care settings. The ACTS tools may be of assistance to you. http://www.adolescentaids.org/healthcare/acts.html
