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Since 2006, <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> retesting during the third trimester and breastfeeding has been recommended by the World Health Organization in higher prevalence (\u22655%) settings to reduce <jats:styled-content style=\"fixed-case\">MTCT<\/jats:styled-content>. However, many countries lack clarity on when and how often to retest pregnant and postpartum women to optimize resources and service delivery. We reviewed and characterized national guidelines on maternal retesting based on timing and frequency.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We identified 52 countries to represent variations in <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> prevalence, geography, and <jats:styled-content style=\"fixed-case\">MTCT<\/jats:styled-content> priority and searched available national <jats:styled-content style=\"fixed-case\">MTCT<\/jats:styled-content>,<jats:styled-content style=\"fixed-case\"> HIV<\/jats:styled-content> testing and <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> treatment policies published between 2007 and 2017 for recommendations on retesting during pregnancy, labour\/delivery and postpartum. Recommended retesting frequency and timing was extracted. Country <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> prevalence was classified as: very low (&lt;1%), low (1% to 5%), intermediate (&gt;5 to &lt;15%) and high (\u226515%). Women with unknown <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> status at delivery\/postpartum were included in retesting guidelines.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results and discussion<\/jats:title><jats:p>Overall, policies from 49 countries were identified; 51% from 2015 or later and most (n\u00a0=\u00a025) were from Africa. Four countries were high <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> prevalence, seven intermediate, sixteen low and twenty\u2010two very low. Most (n\u00a0=\u00a031) had guidance on universal voluntary opt\u2010out <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> testing at the first antenatal care (<jats:styled-content style=\"fixed-case\">ANC<\/jats:styled-content>) visit. Beyond the first <jats:styled-content style=\"fixed-case\">ANC<\/jats:styled-content> visit, the majority (78%, n\u00a0=\u00a038) had guidance on retesting; 22 recommended retesting all women with unknown\/negative status, five only if unknown <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> status, three in pregnancy based on risk and eight combining these approaches. Retesting was universally recommended during pregnancy, labour\/delivery, and postpartum for all high prevalence settings and four of seven intermediate prevalence settings. Five <jats:styled-content style=\"fixed-case\">UNAIDS<\/jats:styled-content> priority countries for <jats:styled-content style=\"fixed-case\">EMTCT<\/jats:styled-content> with low\/very low <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> prevalence, but high\/intermediate <jats:styled-content style=\"fixed-case\">MTCT<\/jats:styled-content>, had no guidance on retesting.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Retesting guidelines for pregnant and postpartum women were ubiquitous in high prevalence countries and defined in some intermediate prevalence countries, but absent in some low <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> prevalence countries with high <jats:styled-content style=\"fixed-case\">MTCT<\/jats:styled-content>. Countries may require additional guidance on how to optimize maternal <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> testing and whether to prioritize retesting efforts or discontinue universal retesting based on <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> incidence. Research is needed to assess country\u2010level guideline implementation and impact.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jia2.25271","type":"journal-article","created":{"date-parts":[[2019,4,8]],"date-time":"2019-04-08T15:11:49Z","timestamp":1554736309000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":36,"title":["Retest and treat: a review of national <scp>HIV<\/scp> retesting guidelines to inform elimination of mother\u2010to\u2010child <scp>HIV<\/scp> transmission (<scp>EMTCT<\/scp>) efforts"],"prefix":"10.1002","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4178-7706","authenticated-orcid":false,"given":"Alison L","family":"Drake","sequence":"first","affiliation":[{"name":"Department of Global Health University of Washington Seattle WA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kerry A","family":"Thomson","sequence":"additional","affiliation":[{"name":"Department of 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