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Voluntary universal antenatal HIV testing

D Mercey1, B A Helps, A Copas

  • 1Academic Department of Genitourinary Medicine, University College London Medical School, UK.

British Journal of Obstetrics and Gynaecology
|November 1, 1996
PubMed
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Universal voluntary human immunodeficiency virus (HIV) testing in antenatal care increased uptake and identified new infections. However, many women declined testing, indicating a need for further research into optimal HIV screening strategies.

Area of Science:

  • Public Health
  • Infectious Diseases
  • Epidemiology

Background:

  • Human immunodeficiency virus (HIV) screening in antenatal settings is crucial for early detection and prevention of mother-to-child transmission.
  • Previous HIV testing rates among antenatal women were low, necessitating a review of testing policies.

Purpose of the Study:

  • To evaluate the effectiveness of a universal voluntary named HIV testing policy for pregnant women.
  • To identify demographic and behavioral factors influencing HIV test uptake in this population.
  • To determine the prevalence of previously undiagnosed HIV infections and compare it with existing monitoring data.

Main Methods:

  • A prospective study was conducted at a Central London teaching hospital antenatal clinic.
  • Data were collected via self-completion questionnaires, booking forms, and virology laboratory records.

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  • 1,374 women were included over a 49-week period.

    • Main Results:

    • HIV testing uptake increased significantly from less than 10 women per year to 41% (548/1340) after policy implementation.
    • Factors associated with higher uptake included Caucasian and Mediterranean ethnicity, fewer previous live births, and multiple lifetime sexual partners.
    • Two new HIV-positive cases were diagnosed (0.36% prevalence), with a similar prevalence (0.24%) found through unlinked anonymous testing.

    Conclusions:

    • Universal voluntary antenatal HIV testing is feasible and effective in increasing uptake and identifying undiagnosed infections.
    • A significant proportion of women opted out of testing, highlighting the need for further investigation into reasons for refusal.
    • Additional research is recommended to explore alternative HIV testing models, reasons for declining tests, and cost-effectiveness of antenatal screening.