Perinatal HIV Testing Guidelines

In order to receive treatment for HIV and reduce the likelihood of transmitting the HIV virus to their newborns, pregnant women first must know their HIV status.

The American College of Obstetricians and Gynecologists (the College) recommends that all pregnant women be screened for HIV as early as possible during each pregnancy following the opt-out testing approach, where the pregnant woman is notified that she will be tested for HIV as part of the routine battery of prenatal blood tests unless she declines.

Additionally, the College recommends a repeat HIV test in the third trimester for women with earlier negative test results who reside in areas with high HIV prevalence, and women known to be at high risk for acquiring HIV infection.

Women who arrive in labor with undocumented HIV status should be tested with a rapid HIV test.

Some states require pre-test counseling and specific informed consent, either verbal or written, before a pregnant woman may be tested for HIV.  This is known as the opt-in testing approach.

If you are unsure about your state’s testing requirement for pregnant women, a complete list of state HIV testing laws and regulations is available from the Centers for Disease Control and Prevention (CDC).

College Committee Opinion #635

Prenatal and Perinatal Human Immunodeficiency Testing: Expanded Recommendations includes College recommendations for prenatal testing, rapid testing in labor and delivery, and repeat testing in the third trimester. 

College Committee Opinion #596

Routine Human Immunodeficiency Virus Screening, includes College recommendations for testing females aged 13-64 years at least once in their lifetime and annually thereafter based on factors related to risk.

College Committee Opinion #595

Preexposure Prophylaxis for the Prevention of Human Immunodeficiency Virus, reflects currently evolving guidance around preexposure prophylaxis for women at risk of HIV infection. 

College Committee Opinion #234

Scheduled Cesarean Delivery and the Prevention of Vertical Transmission of HIV Infection reflects the most current data available regarding the effectiveness of planned cesarean delivery to prevent vertical transmission of HIV.

Joint Statement on HIV Testing by ACOG and AAP

Joint Statement on Human Immunodeficiency Virus Testing by the American College of Obstetricians and Gynecologists and the American Academy of Pediatrics (AAP) outlines the joint College/AAP policy on prenatal HIV testing following the opt-out testing approach.