HIV screening is recommended for all pregnant women as part of the initial lab testing

HIV screening is recommended for all pregnant women as part of the initial lab
testing. The CDC recommends Informed Refusal (or “Opt Out,” where a
patient is tested unless she refuses), rather than Informed Consent (or “Opt In,”
where a patient must specifically consent). Retesting should take place in the
third trimester in areas of high HIV prevalence or an at-risk patient. Rapid HIV
testing in labor is recommended if the patient’s HIV status is not known.
The ELISA test (screening test) assesses presence of detectable HIV
antibodies. A three-month lag exists between HIV infection and a positive
ELISA test. All babies born to HIV-positive women will be HIV-antibody
positive from passive maternal antibodies.
The Western blot test (definitive test) identifies the presence of HIV core
and envelope antigens. Triple antiviral therapy is recommended for all HIVpositive
women starting at 14 weeks and continuing through delivery. With
cesarean delivery and triple antiviral therapy, transmission rates are as low as
1%.