Their numbers include women whose mothers had HIV and who were infected at birth. They now are in their late teens and 20s and are pregnant themselves. “They've taken basically every antiretroviral ever produced, and they have very complex virus to help manage,” she added.
Dr. Cohan expects to soon get more calls like a recent one she fielded regarding a woman who was 36 weeks pregnant with severe, worsening preeclampsia. For some reason, she hadn't been tested for HIV until late in pregnancy, even though her partner had HIV.
Her obstetricians had ordered the standard HIV diagnostic tests, an enzyme-linked immunosorbent assay (ELISA), which came back positive, and a Western blot, with results still pending, leaving her diagnosis unconfirmed. Now they needed to deliver her immediately because of the preeclampsia.
“The question was, what to do for this woman who likely had HIV but no confirmatory diagnosis, which is kind of analogous to getting a positive rapid HIV test,” Dr. Cohan said.
Luckily, the hotline was there to help, as it will be when more providers begin using rapid HIV tests.
Operators are standing by.
Family physician Jessica Folger (left) expects to get more hotline calls once rapid testing becomes available. Shannon Weber/Perinatal Hotline
Who to Call
▸ Perinatal HIV Hotline: 888-448-8765. Advice offered 24/7 on treating HIV-infected pregnant women and their infants, HIV testing in pregnancy, and more.
▸ PEPline (National Clinicians' Postexposure Prophylaxis Hotline): 888-448-4911. Advice offered 24/7 for health care workers exposed to HIV, hepatitis B, and hepatitis C.
▸ HIV/AIDS Warmline: 800-933-3413. Advice on managing nonpregnant patients with HIV or AIDS offered weekdays from 8 a.m. to 8 p.m. EST.
Where to Find Information
▸ Public Health Service Task Force Recommendations for Use of Antiretroviral Drugs in Pregnant HIV-1 Infected Women for Maternal Health and Interventions to Reduce Perinatal HIV-1 Transmission in the United States, dated July 6, 2006:
▸ A sample script and consent form from the Centers for Disease Control and Prevention for informing women in labor who have unknown HIV status about rapid HIV testing:
www.cdc.gov/hiv/rapid_testing/rt-appendix_b.htm
▸ A 2004 overview of state requirements on HIV testing in pregnancy by the Kaiser Family Foundation: