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Acquired immunodeficiency syndrome: suggested protocol for counseling and screening in pregnancy
Insights
A new protocol screened pregnant women for human immunodeficiency virus (HIV). In six months, 3-4% of patients used the service, identifying 11 HIV-positive women and raising medical and ethical considerations.
Area of Science:
- Public Health
- Infectious Diseases
- Obstetrics & Gynecology
Background:
- The Centers for Disease Control (CDC) reported 35,900 acquired immunodeficiency syndrome (AIDS) cases by May 1987, with significant impact on women and children.
- Perinatal transmission was a major concern, accounting for 80% of AIDS cases in children under 13.
- The CDC recommended human immunodeficiency virus (HIV) screening for pregnant women with risk factors.
Purpose of the Study:
- To develop and implement a screening protocol for HIV in pregnant women.
- To address the medical and ethical issues arising from HIV screening in prenatal care.
- To evaluate the initial uptake and outcomes of the developed screening protocol.
Main Methods:
- Development of a comprehensive screening protocol for HIV in pregnancy.
- Implementation of the protocol within prenatal patient services.
- Monitoring of patient engagement with counseling and HIV testing.
Main Results:
- During the first six months, 3-4% of prenatal patients utilized the HIV counseling and screening service.
- Eleven HIV-positive women were identified through the protocol.
- The implementation process highlighted significant medical and ethical challenges.
Conclusions:
- The established protocol facilitated the identification of HIV-positive pregnant women.
- The screening program underscored the need for careful consideration of medical and ethical implications in prenatal HIV testing.
- Further refinement and support are necessary for effective integration of HIV screening in obstetric care.
Abstract:
The Centers for Disease Control (CDC) has recorded 35,900 cases of acquired immunodeficiency syndrome (AIDS) in the United States, including 2447 infected females, as of May 25, 1987. These cases include 503 children under the age of 13, of whom 80% were thought to have been affected through perinatal transmission. The prevalence of AIDS-related complex and human immunodeficiency virus in the United States is far greater than these numbers. The CDC has recommended screening those pregnant women with risk factors for human immunodeficiency virus. With the help of a wide range of professionals, we have developed a screening protocol for human immunodeficiency virus in pregnancy. In the first six months, 3-4% of prenatal patients used this counseling service, and 11 human immunodeficiency virus-positive women delivered. This paper discusses the medical and ethical issues that were raised and the problems that we faced in establishing this protocol.