Rapid HIV Testing

In spite of impressive gains in reducing perinatal HIV transmission in the United States, new infections persist. In late 2002, the FDA approved the rapid HIV test allowing for preliminary diagnosis and treatment of HIV in labor.

If you are caring for a pregnant woman with a positive rapid HIV test who is in labor or an HIV-exposed infant, see the 24/7 Illinois Perinatal HIV Hotline's step-by-step recommendations.

The Perinatal HIV Prevention Act serves as the legal basis for rapid HIV testing in Illinois. Originally passed in August 2003 as Public Act 93-566, it was amended in 2006 and again in 2007. Rules for this Act were promulgated, effective December 18, 2012, and can be found in the Perinatal HIV Prevention Code. The law was most recently amended in August 2017 by Public Act 100-0265 and mandates the following:

  • Standardized and mandated counseling of all pregnant women.

  • Opt-out HIV testing as early in pregnancy as possible.

  • Repeat opt-out HIV testing during the third trimester, ideally by the 36th week of pregnancy (August 2017 amendment).

  • Opt-out rapid HIV testing be offered on labor and delivery to women without a documented HIV test from the third trimester of the current pregnancy (August 2017 amendment).

  • Mandatory rapid HIV testing of newborns to determine HIV-exposure if there is no documentation of maternal HIV testing during the third trimester of pregnancy or at delivery (June 2006/August 2017 amendments).

  • Reporting of all preliminary positive rapid HIV tests on mothers and infants within 12 hours, but no later than 24 hours, of the test result to the 24/7 Illinois Perinatal HIV Hotline at 1-800-439-4079 to ensure medical consultation and linkage to case management (June 2006/August 2017 amendments).

  • Documentation of HIV test results in prenatal, labor and delivery, and newborn pediatric charts.

The Perinatal Rapid Testing Implementation Initiative (PRTII), funded by the Illinois Department of Public Health between 2004-2011, was established to assist hospitals in implementing rapid HIV testing in labor and delivery units throughout Illinois. By late 2005, all labor and delivery units in the state were conducting rapid HIV testing. Since 2011, the state health department has provided limited rapid testing and reporting support through the Pediatric AIDS Chicago Prevention Initiative.