Pregnant women at risk for HIV may opt out of testing

NEW YORK (Reuters Health) - Women who decline prenatal HIV screening are more likely to be HIV positive than women who undergo prenatal HIV screening, according to a study from Canada.

Dr. Ameeta E. Singh from University of Alberta, Edmonton, Alberta, Canada and associates compared the characteristics and HIV prevalence of women undergoing prenatal infectious disease screening who accepted prenatal HIV testing with those of women who declined prenatal HIV testing in Alberta from 2002 through 2004.

Fewer than 4 percent of more than 110,000 women opted out of HIV testing, they report.

The prevalence of newly diagnosed HIV cases was 3.3 times greater among the opt-out group (0.07 percent) than among women who were tested (0.02 percent), they also report.

"This may indicate that women at higher risk for HIV infection are opting out of testing," the investigators say.

The identities of the women opting out of testing were not known at the time of analysis. "It was, therefore, not possible to survey them regarding their reasons for opting out of testing," Singh told Reuters Health.

"HIV testing in pregnancy is essential to improving health care for HIV infected women and to prevent mother-to-child transmission of HIV," Singh stressed. "Anything less than truly universal HIV testing in pregnant women is likely to result in missed opportunities to prevent mother-to-child transmission of HIV."

SOURCE: Clinical Infectious Diseases, December 15, 2007.