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J Acquir Immune Defic Syndr. 2015 Aug 15;69(5):610-4. doi: 10.1097/QAI.0000000000000669.

Brief Report: HIV Testing Among Pregnant Women Who Attend Antenatal Care in Malawi.

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*Department of HIV and AIDS, Ministry of Health, Lilongwe, Malawi; †Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland; ‡International Training and Education Centre for Health/Department for Global Health, University of Washington, Seattle, WA; §Dignitas International, Zomba, Malawi; ‖Department of Medicine, College of Medicine, University of Malawi, Blantyre, Malawi; ¶International Training and Education Centre for Health Malawi, Lilongwe, Malawi; #Division of Epidemiology and Biostatistics, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa; and **International Training and Education Center for Health Malawi, Lilongwe, Malawi.


Malawi adopted the Option B+ strategy in 2011. Its success in reducing mother-to-child transmission depends on coverage and timing of HIV testing. We assessed HIV status ascertainment and its predictors during pregnancy. HIV status ascertainment was 82.3% (95% confidence interval: 80.2 to 85.9) in the pre-Option B+ period and 85.7% (95% confidence interval: 83.4 to 88.0) in the Option B+ period. Higher HIV ascertainment was independently associated with higher age, attending antenatal care more than once, and registration in 2010. The observed high variability of HIV ascertainment between sites (50.6%-97.7%) and over time suggests that HIV test kit shortages and insufficient numbers of staff posed major barriers to reducing mother-to-child transmission.

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