Testing for HIV in the antenatal clinic: the views of midwives

Self administered questionnaires were given to 34 midwives, who regularly counsel parturient women about the HIV antibody test, to investigate their attitudes to the test being offered in the antenatal clinic. Most of the midwives felt that testing should not be compulsory and that the test should be offered to all pregnant women who ask for it, not only those in recognized risk groups. Most also felt that women should be told the results of the test and that it should not be the midwives aim to increase the number of women having the test. Most felt that all midwives should counsel about the test but would like health advisers, GPs and obstetricians to be involved also. They also felt that they did not have sufficient knowledge in some areas to counsel particularly with regard to the practical and psychological implications of being HIV positive. This has implications in terms of the provision of adequate pre-test counselling for all pregnant women as an improvement in counselling services requires an allocation of finances, e.g. for training of midwives, which may be seen as unnecessary in areas of low seroprevalence. Further discussion and debate of these issues is required.