Successes With Use Of Rapid Versus Elisa Testing In The Implementation Of Pmtct Programs

UNC Project, with funding from the Elizabeth Glaser Pediatric AIDS Foundation and UNICEF- Malawi, put in place a PMTCT program within 4 Lilongwe sub-urban government public health centers. The program reaches over 18,000 pregnant women attending antenatal clinic and offers VCT and single-dose Nevirapine intervention to the mother-infant pairs. The program started in April 2002 with one site and increased to 4 by April 2003. ELISA HIV tests were used initially, requiring women to return after one week for results. In July 2003, rapid on-site testing was introduced using two parallel tests. ELISA tests are done on 10% of all tests for quality control. We compared antenatal women who received ELISA with those offered rapid tests to detennine (1) VCT acceptance rate and (2) the proportion that returned for results. 11,724 clients were tested between January and December 2003. Over the 12 months, 78% of the women who were offered rapid HIV testing accepted VCT compared with 36% of those who were offered ELISA tests. Also, post-test counseling rate was 97% in the rapid test arm compared to 78% who had an ELISA test.