Voluntary, named testing for HIV in a community based antenatal clinic: a pilot study

Abstract

Despite the increasing advantages of identifying HIV infection in pregnant women, only some 12% of HIV positive women attending antenatal clinics in London have been identified by named testing. As virtually all antenatal care will be community based within the next two to three years, we assessed the problems of introducing named HIV testing during pregnancy into the primary care setting. Planning the service took a considerable time and required the production of educational material for both staff and pregnant women and some reorganisation of procedures. Over a one year period an uptake of 44% was noted. Several problems were encountered including an average of 21 minutes needed to give information on AIDS and HIV, an adverse effect on the midwife-mother relationship, and anxiety (affecting both women and midwives). Possible solutions to this difficult problem are discussed.

Rapid HIV diagnostic test in undocumented pregnant women applied at an inner-city teaching hospital

“…Significant differences are described nationwide between patients attended at private and public maternities. Similar to the results obtained here, several authors have reported that pregnant women who come from less privileged social conditions, such as low income and poor access to prenatal care, are usually not counseled and tested for HIV 7,14,17,24 . In these situations, rapid HIV testing is of special interest.…”

Would Universal Antenatal Screening for HIV Infection Be Cost‐Effective in a Setting of Very Low Prevalence? Modelling the Data for Australia

“…However, for all scenarios, we assumed that the uptake of screening would remain at 95% and that informed consent would be obtained in an ethical manner. The literature [45,59,[66][67][68][69][70][71][72][73][74][75] suggests that high compliance and ethical screening is determined by careful and sensitive pretest counselling, the level of training for each health-care professional, a need to take particular care when English is not the first language (in countries where English is the most commonly spoken language), and the age, attitudes, and experience of the health-care professionals. On the basis of this, we recommend that appropriate investments be made in continuing professional education.…”

Uptake and acceptability of antenatal HIV testing: randomised controlled trial of different methods of offering the test

“…Minimal information may be more likely to achieve high uptake 7 8 9. Comprehensive information aims to ensure informed choice but may result in high costs in midwives' time and increased anxiety 10. Studies have examined the outcomes of the different policies,4 5 6 7 8 9 10 11 but the different methods have not been compared systematically, with an evaluation of the direct impact on women.…”

“…Comprehensive information aims to ensure informed choice but may result in high costs in midwives' time and increased anxiety 10. Studies have examined the outcomes of the different policies,4 5 6 7 8 9 10 11 but the different methods have not been compared systematically, with an evaluation of the direct impact on women. Although most women are at low risk, the offer of the test may itself cause anxiety, as has been found with other antenatal tests,12 and feelings of resentment about being offered the test may reduce satisfaction with the care provided.…”