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

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.

Keywords

HIV testing - repeat HIV testing - perinatal HIV - third-trimester HIV test - HIV seroconversion

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.

Publication History

Received: 05 December 2022

Accepted: 10 September 2023

Article published online:
18 October 2023

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