Introduction of rapid syphilis testing in antenatal care: A systematic review of the impact on HIV and syphilis testing uptake and coverage

BackgroundGlobal guidelines recommend universal syphilis and HIV screening for pregnant women. Rapid syphilis testing (RST) may contribute toward achievement of universal screening.ObjectivesTo examine the impact of RST on syphilis and HIV screening among pregnant women.Search strategyWe searched MEDLINE for English- and non-English language articles published through November, 2014.Selection criteriaWe included studies that used a comparative design and reported on syphilis and HIV test uptake among pregnant women in low- and middle-income countries (LMICs) following introduction of RST.Data collection and analysisData were extracted from six eligible articles presenting findings from Asia, Africa, and Latin America.Main resultsAll studies reported substantial increases in antenatal syphilis testing following introduction of RST; the latter did not appear to adversely impact antenatal HIV screening levels at sites already offering rapid HIV testing and may increase HIV screening among pregnant women in some settings. Qualitative data revealed that women were highly satisfied with RST. Nevertheless, ensuring adequate training for healthcare workers and supplies of commodities were cited as key implementation barriers.ConclusionsRST may increase antenatal syphilis and HIV screening and contribute to the improvement of antenatal care in LMICs.