Expedited human immunodeficiency virus testing of mothers and newborns with unknown HIV status at time of labor and delivery

New York State introduced the first statewide program in the U.S, of expedi ted HIV testing (48-hour turn-around results) of mothers with unknown HIV s tatus at the time of labor or delivery and their newborns on August 1, 1999 . We evaluated the results of this program during its first 5 months at Lin coln Medical and Mental Health Center (Lincoln Hospital) in the Bronx, New York. There were 1,274 total live birth deliveries between August 1 and Dec ember 31, 1999. The HIV infection status of 539 mothers (42.3%) was unknown to medical providers in the labor-delivery suite, either due to lack of te sting during the current pregnancy or unavailability of HIV documentation a t the time of delivery. During labor and delivery, a total of 462 (85.7%) m others with unknown HIV status consented to expedited HIV testing (Single U se Diagnostic System for HIV-1 antibody or SUDS). The newborns of 77 mother s (14.3%) who did not consent were tested immediately after birth. Seventee n tested positive for HIV-1 antibody by the SUDS test. The results of 10 of these infants (58.8%) were subsequently confirmed positive for HIV-1 antib ody by Western Blot analysis. This new rapid HIV testing program facilitate d early diagnosis of these previously unknown HIV-exposed infants, although the low positive predictive value of the test in our community calls for c areful communication of these results pending confirmation.