Testing for HIV in pregnancy: 3 years experience in Edinburgh city

Since HIV testing became available in Edinburgh in September 1985, testing in pregnancy has been offered (after counselling and with informed consent) on a selective or case finding basis. This study reviews the results of the first three years for all Edinburgh city hospitals. HIV serostatus was known for 436 such pregnant individuals during this time, and 79 women were known to be infected with HIV. There was little change in the number of first tests done in pregnancy, a decline in the number of women discovered during pregnancy to be seropositive, and a corresponding increase in women referred known to be HIV infected. With one exception, all seropositive women gave a history of injecting drug use or having a steady drug using sexual partner known to be HIV seropositive. Forty-five per cent of pregnant women with the former risk, and 16% of pregnant women with the latter risk were HIV seropositive. The minimum prevalence of HIV infection for women domiciled in Edinburgh city was approximately 0.4% of pregnancies, with a higher prevalence in women having induced abortion and a lower prevalence in continuing pregnancies. However, HIV serostatus was known in only 1.6% of all pregnancies. HIV infection in pregnant Edinburgh women may be confined largely to a cohort of injection drug users and sexual partners of infected male drug users but total population prevalence data are urgently required.