A protocol for routine voluntary antepartum human immunodeficiency virus antibody screening

Human immunodeficiency virus infection among both women of reproductive age and their infants is rapidly increasing. One strategy to address this increase involves the offering of routine voluntary antepartum human immunodeficiency virus antibody counseling and testing. The rationale for this policy is that all prenatal patients are educated about the major modes of viral transmission and encouraged to practice risk reduction behavior. Human immunodeficiency virus-infected women receive comprehensive prenatal care; they are referred for medical follow-up, and their infants are identified and targeted for pediatric infectious disease follow-up. During the past 4 years we have developed a protocol for antepartum human immunodeficiency virus screening in our institution. The protocol includes a self-reported human immunodeficiency virus risk behavior profile, pretest counseling conducted by trained human immunodeficiency virus counselors in small groups, written informed consent for human immunodeficiency virus antibody testing, posttest counseling, and education. By following this protocol we have identified and referred for follow-up > 350 human immunodeficiency virus-infected women.