Mentored Scientist Award

The current practice of single HIV antibody testing for pregnant women in high prevalence areas fails to identify those at risk of acquiring and, in turn, transmitting HIV throughout pregnancy and lactation. The objective of this study is to assess the acceptability and feasibility of serial HIV antibody testing among HIV-uninfected pregnant and breastfeeding women from the initiation of antenatal care until 24 weeks postpartum in Tororo, Uganda. This is a prospective study of 500 HIV-uninfected pregnant women receiving care at the Tororo District Hospital. Serial HIV antibody testing will be performed throughout pregnancy and the postpartum period at intervals of 2-3 months. Male partners will also be recruited for one-time HIV antibody testing at study entry. The primary outcome is the proportion of women with >1 follow-up HIV test during pregnancy and > 2 during lactation. Secondary outcomes are the proportion of women and male partners who accept testing, prevalence of discordant partnerships and new HIV diagnosis among women. This study will be conducted in a high volume prenatal clinic where the population has an HIV seroprevalence of 8%. These pilot data will be used to design a larger study comparing different HIV testing algorithms for the identification of acute and incident HIV among pregnant and lactating women.