HIV Sentinel Surveillance Among Women Seeking Elective Pregnancy Termination, San Francisco

Drey, Eleanor A.; Darney, Philip D.; Louie, Brian; Kellogg, Timothy A.; Kang, Mi-Suk; Prabhu, Roop; Whitaker, Amy K.; Chin, Jennie; Molina, A. Padilla-Malo de; McFarland, Willi

doi:10.1097/01.olq.0000175420.35851.6b

Cited by 6 publications

(3 citation statements)

References 8 publications

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“…Published studies from the USA9 and data from London report rates of between 0.1% and 0.87% with a testing acceptance rate of >96% 10. Prevalence of HIV among pregnant women in 2008 was 0.15% in England (excluding London) and 0.39% in London [Health Protection Agency (HPA) data] but very few data are available on the prevalence of HIV in patients attending colposcopy clinics and TOP services across the UK.…”

Section: Discussionmentioning

confidence: 99%

HIV testing in colposcopy and termination of pregnancy services: a missed opportunity?

Briggs

Partridge

Bates

2011

J Fam Plann Reprod Health Care

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IntroductionThe 2008 National HIV testing guidelines produced jointly by the British Association of Sexual Health and HIV, British HIV Association and British Infection Society recommend HIV testing for patients attending termination of pregnancy (TOP) services and patients diagnosed with cervical intraepithelial neoplasia (CIN) Grade 2 or above. The aim is to reduce the time between acquisition and diagnosis of HIV by encouraging testing in settings where patients present with indicator diseases. Benefits of earlier HIV diagnosis include improved survival, prevention of onward transmission, and optimisation of maternal health when planning pregnancy. There is evidence that HIV reduces the effectiveness of standard treatment for CIN 2/3 and cervical cancer. The experience of antenatal screening indicates that the majority of women accept HIV screening if it is offered as part of a package of care.MethodsThis retrospective case notes review of 60 HIV-positive women, diagnosed between 1 January 2006 and 31 July 2009, collected data on age, ethnicity, length of time in the UK, timing of HIV diagnosis and possible timing of acquisition relative to attendance at colposcopy or TOP services, CD4 count and symptoms at diagnosis and cervical cytology history.ResultsThe authors found that three (5%) women were diagnosed with CIN Grade 2 or above prior to HIV diagnosis; HIV testing at the time of TOP may have resulted in earlier diagnosis for three (5%) women. There was at least one missed opportunity for earlier diagnosis in five (8%) cases.ConclusionsThe authors suggest further work should be undertaken to establish HIV prevalence in TOP and colposcopy services and that HIV testing should become standard practice in the management of CIN 2/3 and cervical cancer.

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Section: Discussionmentioning

confidence: 99%

HIV testing in colposcopy and termination of pregnancy services: a missed opportunity?

Briggs

Partridge

Bates

2011

J Fam Plann Reprod Health Care

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“…However, we did find a number of HIV prevalence studies in individuals falling into this category. We used methods previously described by Zou et al (20) for estimating the incidence of a disease from the prevalence by comparing to a population where both incidence and prevalence are known, with studies of incidence and prevalence in IDUs as the comparison group to estimate incidence in CSWs (21–43).…”

Section: Methodsmentioning

confidence: 99%

Risk of Window Period HIV Infection in High Infectious Risk Donors: Systematic Review and Meta-Analysis

Kucirka

Sarathy

Govindan

et al. 2011

American Journal of Transplantation

141

133

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The OPTN defines high risk donors (HRDs), colloquially known as 'CDC high risk donors' , as those thought to carry an increased risk of HIV window period (WP) infection prior to serologic detectability. However, the true risk of such infection remains unknown. To quantify the risk of WP infection in each HRD behavior category, we performed a systematic review and metaanalysis of studies of HIV prevalence and incidence. Of 3476 abstracts reviewed, 27 eligible studies of HIV infection in HRD populations were identified. Pooled HIV incidence estimates were calculated for each category of HRD behavior and used to calculate the risk of WP HIV infection. Risks ranged from 0.09-12.1 per 10 000 donors based on WP for ELISA and 0.04-4.9 based on nucleic acid testing (NAT), with NAT reducing WP risk by over 50% in each category. Injection drug users had the greatest risk of WP infection (4.9 per 10 000 donors by NAT WP), followed by men who have sex with men (4.2:10 000), commercial sex workers (2.7:10 000), incarcerated donors (0.9:10 000), donors exposed to HIV through blood (0.6:10 000), donors engaging in highrisk sex (0.3:10 000) and hemophiliacs (0.035:10 000). These estimates can help inform patient and provider decision making regarding HRDs.

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“…Data from a consecutive sample of 482 adolescents (age Ͻ 20 years) presenting for abortion at San Francisco General Hospital in 2002 were collected as part of a blinded HIV seroprevalence survey in the clinic population [7]. The study received the approval of the Committee on Human Research of the University of California, San Francisco.…”

Section: Methodsmentioning

confidence: 99%

Contraceptive Intentions among Adolescents after Abortion

Truong

Kellogg

McFarland

et al. 2006

Journal of Adolescent Health

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HIV Sentinel Surveillance Among Women Seeking Elective Pregnancy Termination, San Francisco

Abstract: Women electing pregnancy termination can serve as a sentinel population to track trends in the HIV epidemic. However, barriers remain to wider implementation of the approach as a surveillance tool.

Cited by 6 publications

References 8 publications

HIV testing in colposcopy and termination of pregnancy services: a missed opportunity?

HIV testing in colposcopy and termination of pregnancy services: a missed opportunity?

Risk of Window Period HIV Infection in High Infectious Risk Donors: Systematic Review and Meta-Analysis

Contraceptive Intentions among Adolescents after Abortion

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