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Review of antenatal testing policies and practice for HIV and hepatitis C infection
Jenean D Spencer1, Diane Tibbits, Christine Tippet
1Surveillance and Epidemiology Section, Population Health Division, Commonwealth Department of Health and Ageing, Australian Capital Territory.
Insights
Antenatal screening for HIV and HCV in Australia shows significant variation in policy and practice among healthcare providers. This lack of consistent approach may stem from differing guidelines from clinical and public health organizations.
Area of Science:
- Public Health
- Infectious Disease Epidemiology
- Maternal Health
Background:
- Antenatal screening for Human Immunodeficiency Virus (HIV) and Hepatitis C Virus (HCV) is crucial for maternal and infant health.
- Understanding current testing policies and practices in Australia is essential for identifying gaps and improving outcomes.
Purpose of the Study:
- To investigate the antenatal Human Immunodeficiency Virus (HIV) and Hepatitis C Virus (HCV) testing policies and practices across Australia.
- To identify variations in testing approaches among different healthcare settings and provider types.
Main Methods:
- A national survey was conducted targeting private obstetricians, general practitioners (GPs), and public hospital obstetric units.
- Response rates were high, with 85% of surveys returned, and data collected on antenatal testing policies, uptake, and prevalence of HIV and HCV.
Main Results:
- Significant variability was observed in antenatal HIV and HCV testing policies and practices across Australia.
- In 1999, an estimated 33% of pregnant women were tested for HIV and 37% for HCV, with prevalence rates of 0.23/1,000 for HIV and 13/1,000 for HCV.
- The proportion of providers with established testing policies varied, as did the universal offer of testing.
Conclusions:
- Antenatal HIV and HCV testing policies and practices in Australia are not uniform.
- This lack of consistency may be attributed to differing guidelines from various clinical and public health bodies.
Objective:
To investigate antenatal HIV and HCV testing policy and practice in Australia.
Methods:
A survey of private obstetricians and general practitioners (GPs) affiliated with the Royal Australian and New Zealand College of Obstetricians and Gynaecologists and directors of obstetric units in public hospitals was undertaken. Surveys were mailed to 40% and 20% random samples of private obstetricians and GPs, respectively, and all public hospital obstetric units. The questionnaires included information on type of antenatal policy, proportion of women tested for HIV and HCV, and number of HIV and HCV-positive women receiving antenatal care.
Results:
Of the 995 surveys distributed, 847 (85%) were returned. Of these 847, 277 (33%) were returned from practitioners or hospitals no longer involved in antenatal care. The response rates from the remaining practitioners (n=570) included 87% from private obstetricians, 78% from GPs, and 71% from public hospitals. The proportion of private obstetricians, GPs and public hospitals with an antenatal testing policy for HIV was 62%, 42% and 44%, and for HCV 65%, 41% and 39%, respectively. Universal offer of antenatal testing among private obstetricians, GPs and public hospitals was 47%, 62% and 23% for HIV and 54%, 46% and 23% for HCV, respectively. During 1999, an estimated 33% of pregnant women were tested for HIV and 37% for HCV. Based on reported numbers of women in antenatal care, prevalence rates were estimated at 0.23 per 1,000 and 13 per 1,000, for HIV and HCV, respectively.
Conclusions:
Antenatal testing policy and practice varies widely in Australia. The lack of uniformity may reflect differing policies among clinical and public health bodies.
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