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Evaluation of an antenatal HIV testing programme in an inner London health district
J Hawken1, T Chard, D J Jeffries
1Department of Obstetrics and Gynaecology, St Bartholomew's Hospital, London.
Objective:
To study an antenatal human immunodeficiency virus (HIV) testing programme in an inner London health district.
Design:
A standardised research interview was given to women in the first half of pregnancy and the findings were compared with those of the routine clinical interview. The observations were analysed in relation to the results of HIV antibody testing, either attributable by consent or anonymously, in these women.
Setting:
The Homerton Hospital, London.
Subjects:
Three thousand seven hundred and twenty-nine women, of whom 1696 (45.5%) consented to testing.
Results:
Four women who had consented to testing had a positive result. Amongst the 2,033 women (54.5%) who declined the test, four (or five) had a positive result. The number of risk factors ascertained by the research study interview was substantially greater than that elicited by the preceding routine interview. In addition, more information was obtained by a routine computer interview than by its unstructured equivalent. There was no obvious association between the presence of a risk factor and whether or not the women had consented to the test.
Conclusions:
Our formal voluntary testing programme detected nearly 44% of HIV seropositive individuals. Thus, there were four known positives during the study period against a total of nine detected by anonymous testing. Since all the known positive results in the study were associated with recognised risk factors, there is some doubt as to the value of a universal testing programme. However, if testing is to be based upon the existence of a risk factor elicited at the booking history, then the deficiencies in this history revealed by the present study need to be corrected.