Prevention of perinatal HIV transmission: are there alternatives to pre-pregnancy serological screening in Kinshasa, Zaire?

Complete obstetrical and medical histories were obtained from 6312 women between ages 15-45 who had undergone HIV serological tests. Individual factors were examined for sensitivity specificity and positive predictive value of HIV infection. No individual risk factors for HIV infection were identified which had sensitivities >60%. Combinations of factors were modelled by logistic regression. Only a model which included indicators of present illness with AIDS/HIV-related symptoms (chronic fever diarrhea or profound weight loss) was predictive of HIV serostatus. These results suggest that identification of healthy women at high risk of HIV infection using nonserological information is not feasible. Thus since the yearly cost of universal serological screening is prohibitively expensive in Zaire HIV/AIDS education and prevention campaigns may be a more cost-effective means of preventing perinatal HIV transmission. (authors modified)