384. Getting to Zero:  Improving Perinatal HIV Screening of Pregnant Women with Education and Hospital Protocol in a Community Hospital
Session: Poster Abstract Session: HIV Epidemiology: Screening and Testing - Outpatient to Inpatient
Thursday, October 8, 2015
Room: Poster Hall
Posters
  • #384_IDWSANDIEGO.GALANG.pdf (534.4 kB)
  • Background:    Near elimination of perinatal human immunodeficiency virus (HIV) transmission in the United States reflects one of the most successful medical and public health intervention in the past 3 decades.   New HIV diagnosis in 0-12 years old in Michigan is 0.2/100,000 in 2012.  HIV testing of pregnant women in our hospital was around 60% in 2010.  In January 2012, a mother was diagnosed with HIV at 36 weeks of pregnancy, which was a sentinel event.  This prompted revisiting strategies to improve HIV testing of pregnant women in our institution. 

    Methods:   In January 2012, we formed a perinatal HIV prevention group and started educational campaign targeting providers and health care workers caring for women and newborns.  Focused work group meetings, lectures and modules were completed.  A hospital based protocol (see figures) was implemented on October 1, 2012.  Data on maternal and newborn HIV testing was collected on following timeframes: October 1, 2011 to September 30, 2012 and October 1, 2012 to March 30, 2015.

    Results:   2033 pregnant women were identified from Oct 1, 2011 to Sept 30, 2012 and 1582 (77.8%) had an at least one HIV test at some point during the pregnancy.  About 1% (20/1582) had screening only during labor/delivery (L&D) encounter.  One newborn was screened.  From October 1, 2012 to March 30, 2015, 95.3% (4761/4994) of pregnant women had at least one HIV test during pregnancy; about 6.8% of those tested had screening only during L&D.  Five neonates were screened.  There were 4 new HIV infections in pregnancy recognized the year prior to protocol implementation and 3 new HIV infections in pregnancy in the 30 months of protocol in place.

    Conclusion:   Staff education and hospital-wide protocol improved maternal HIV screening in our institution.  Routine testing of newborns who did not have documented maternal HIV test however did not become routine with the intervention.  More engagement of providers caring for postpartum women and newborns is important to pursue. 

    Minerva Galang, MD1, Thomas Balaskas, MD2, Vanessa Braden, BS3, Mary Schubert, MSN4, John Hartmann, MD2, Constance Leahy, MD2 and Nnaemeka Egwuatu, MD, MPH1, (1)Infectious Diseases, Mercy Health Saint Mary's, Grand Rapids, MI, (2)Obstetrics & Gynecolocy, Mercy Health Saint Mary's Hospital, Grand Rapids, MI, (3)Clinical Quality Management, Mercy Health Saint Mary's Hospital, Grand Rapids, MI, (4)Maternal Child Services, Mercy Health Saint Mary's Hospital, Grand Rapids, MI

    Disclosures:

    M. Galang, None

    T. Balaskas, None

    V. Braden, None

    M. Schubert, None

    J. Hartmann, None

    C. Leahy, None

    N. Egwuatu, None

    Findings in the abstracts are embargoed until 12:01 a.m. PDT, Wednesday Oct. 7th with the exception of research findings presented at the IDWeek press conferences.