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[Frequency and practice of prescribing prenatal HIV tests during pregnancy]
C D'Ubaldo1, A Vucetich, R Brancatella
1Centro di Riferimento AIDS, IRCCS Lazzaro Spallanzani, Roma.
Background:
To assess frequency and practices of antenatal HIV testing.
Methods:
Cross-sectional study. Site: obstetric units of San Paolo Hospital, Milan (teaching, public, 60 beds, 1500 deliveries/years, reference centre for HIV and pregnancy) and of Sandro Pertini Hospital, Rome (public, urban, 36 beds, 1500 deliveries/year).
Participants:
parturients consecutively admitted for delivery, in the last three months of 1997.
Intervention:
interview by a structured questionnaire. Out-comes: frequency and practices of antenatal HIV testing.
Results:
About 79% of the 500 parturients admitted at the San Paolo Hospital and 57% of the 300 at the Pertini Hospital had been tested for HIV during the current pregnancy (p < 0.001). Overall, in 91% of cases (507/555) the test has been requested by the woman's gynecologist with other antenatal tests. Discussion on HIV testing, infection and pregnancy lasted less than 5 minutes in 92% of San Paolo parturients, and in almost all (99.4%) of the Pertini women. Women in the San Paolo hospital had HIV information available by leaflets in 47% of cases in comparison to 35% of those at the Pertini hospital.
Conclusions:
In Italy, HIV testing seems to be routinely included in the management of pregnancy, although the uptake and practices of offering the test seem not always appropriate. The higher uptake and the better practice seem to correlate with the higher involvement of San Paolo hospital in the fields of HIV infection in pregnancy. However, the reported overall 71% of tested parturients suggests that in Italy we are still far away from a universal antenatal HIV testing. Specific guidelines should be issued in order to implement and to uniform universal antenatal HIV testing, and to optimize the management of infected women.