[Testing for HIV infection in pregnant women at the obstetric centers in Italy]

To assess antenatal HIV testing policy implemented in Italian obstetric centres.

Cross-sectional study, Site and Participants: Italian obstetric centres.

structured postal questionnaire. Out-comes: policies and practices of antenatal HIV testing in Italian obstetric centres.

A total of 213 centres, accounting for a total of 167.927 deliveries/year (30% of the Italian number of deliveries) filed out the questionnaire. Of these, 45% reported having a policy on HIV antenatal testing. Having a policy on antenatal testing is associated to the number of observed HIV-positive women. HIV testing is offered to all women in 89% of centres, included in routine antenatal tests in 67%, with an opt out (57.5%) or on opt in (10.5%) on request. HIV testing is performed at the initial clinic visit in 78% of centres; it is offered routinely to male partners in 7.5% of centres. Amongst centres which observed HIV-positive pregnant women, 47% reported zidovudine is not available as a measure of HIV vertical transmission prevention.

In Italy, HIV testing seems to be routinely included in management of pregnancy, although the practices of offering the test seem not always appropriate and the availability of measures for reducing the risk of vertical transmission not adequate. Specific guidelines should be issued in order to implement and to uniform universal antenatal HIV testing, and to optimize the management of infected women.