The health of the nation : key area handbook: HIV/AIDS and sexual health / Department of Health.

  • Great Britain. Department of Health.
Date:
1993
Catalogue details

Licence: Open Government Licence

Credit: The health of the nation : key area handbook: HIV/AIDS and sexual health / Department of Health. Source: Wellcome Collection.

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    9.3 9.4 10. 11. 11.1 Offering an HIV test to all women receiving antenatal care has resource implications and it would not be sensible to introduce it throughout the country, especially in rural areas with a very low prevalence of HIV. Higher levels of infection are likely to be found in urban areas, particularly in the inner cities. | The decision to offer HIV antibody testing to all women attending an antenatal clinic should be based on knowledge of the local prevalence of HIV infection, the local demography and on any other information that suggests that there could be a significant incidence of HIV infection in the area, for example the prevalence of injecting drug misuse. The local policy should therefore be decided following consultation with the consultant obstetrician(s), the head of midwifery, local Director of Public Health Medicine, the pathology services and the local director of anonymised antenatal studies if these are being carried out in the locality. Alternatively, the Communicable Disease Surveillance Centre could be consulted about anonymised serosurvey results in demographically similar districts. Annex B sets out a costings model prepared by the Department’s Economics and Operational Research Division which should assist in reaching a decision. WHEN to offer testing? Ideally testing should be offered as early as possible in pregnancy. This may miss a very small proportion of women who are in the window period of seroconversion or who become infected during their pregnancy. Women who believe that they have been at recent risk of infection but test negative should be offered a further test later in pregnancy. They should be counselled to ensure that they understand that in spite of the negative test they may be infected and infectious. Women who book late in pregnancy should also be offered the test in the same way as those who book early. HOW to offer such testing? The test must only be performed with the woman’s explicit consent (see paragraph 5) obtained after appropriate pre-test discussion in private. Consent may be obtained by midwives or doctors who have received training about the issues or by specialist counsellors. 1 oko HIV/AIDS AND SEXUAL HEALTH