Am J Perinatol 2024; 41(03): 241-247
DOI: 10.1055/s-0043-1775974
SMFM Fellowship Series Article

Statewide Implementation of Universal Third-Trimester Repeat HIV Testing in Illinois

Lynn M. Yee
1   Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
2   24/7 Illinois Perinatal HIV Hotline, Chicago, Illinois
,
Laurie D. Ayala
2   24/7 Illinois Perinatal HIV Hotline, Chicago, Illinois
,
Alexis M. Roach
3   Mother and Child Alliance (MACA), Chicago, Illinois
,
Anne Statton
3   Mother and Child Alliance (MACA), Chicago, Illinois
,
Sukhdeep Randhawa
3   Mother and Child Alliance (MACA), Chicago, Illinois
,
Patricia M. Garcia
1   Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
2   24/7 Illinois Perinatal HIV Hotline, Chicago, Illinois
,
Emily S. Miller
1   Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
2   24/7 Illinois Perinatal HIV Hotline, Chicago, Illinois
3   Mother and Child Alliance (MACA), Chicago, Illinois
4   Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, The Warren Alpert Medical School, Brown University, Providence, Rhode Island
› Author Affiliations
Funding None.

Abstract

Objective This article aims to assess statewide uptake of HIV repeat testing in the first 2 years after the implementation of an amendment to the Illinois Perinatal HIV Prevention Act (IPHPA) mandating universal repeat HIV testing in the third trimester.

Study Design This is a retrospective, population-based study of all birthing individuals in Illinois (2018–2019). Data were collected using the state-mandated closed system of perinatal HIV test reporting. We evaluated the incidence of mother–infant pairs with negative early tests and repeat third-trimester tests (RTTTs) performed in adherence with the law, as well as the timing of the performance of the RTTTs (outpatient vs. inpatient). Chi-square tests of trend by quarter were performed to ascertain sustainability.

Results Of 138,805 individuals delivered in 2018, 80.6% presented with early test and RTTTs. In 2018, outpatient RTTTs improved from 71.8% (quarter 1) to 85.1% (quarter 4; p < 0.001). In 2018, the proportion of mother–infant dyads who received testing that was adherent to the IPHPA Amendment was 92.1, 95.5, 96.7, and 96.4% in quarters 1 through 4, respectively (p < 0.001). In 2019, outpatient RTTTs performance remained high (87.4%) and stable (p = 0.06). In 2019, 99.9% of mother–infant dyads had testing adherent to the mandate in quarters 1 through 4 (p = 0.39). Of individuals who presented without RTTTs, 93.5% (2018) and 98.8% (2019) underwent inpatient testing before delivery.

Conclusion Implementation of RTTTs in Illinois was rapid, successful, and sustained in its first 2 years. Public health methodologies from Illinois may benefit other states implementing RTTT programs.

Key Points

  • In 2018, Illinois enacted statewide RTTT for HIV among all parturients.

  • In 2019, over 99% of mother–infant dyads had documentation of both early and repeat HIV testing before hospital discharge.

  • Implementation of repeat third-trimester HIV testing in Illinois was rapid, successful, and sustained in its first 2 years.

  • Public health methodologies from Illinois may benefit other states implementing similar programs.

Note

A portion of these data were presented as a poster presentation at the 2020 Society of Maternal-Fetal Medicine 40th Annual Meeting in Grapevine, Texas.


Supplementary Material



Publication History

Received: 05 December 2022

Accepted: 10 September 2023

Article published online:
18 October 2023

© 2023. Thieme. All rights reserved.

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