RISK-FACTORS FOR HIV-INFECTION OVERLOOKED IN ROUTINE ANTENATAL CARE

We have ascertained the extent to which risk factors for HIV infection may escape detection by standard history-taking procedures in an ante natal clinic This study was based on 1264 women from a multi-ethnic po pulation in an inner London health district (City and Hackney). All ha d agreed to undergo attributable HN testing and a detailed personal in terview. Thirty-nine per cent (494 of 1264 women) reported risk factor s contributed personally or by a partner. Most of these risk factors h ad not been earlier disclosed by routine history taking. In most cases the risk was residence and risk activity in a World Health Organizati on (WHO) Pattern 2 country. [HIV spread WHO categories: Pattern 1-prin cipally homosexual/bisexual mates and i.v. drug use (areas=North Ameri ca, Western Europe, Australasia, parts of South America) with male to female ratio 10/1; pattern 2-Heterosexual (areas=Sub Saharan Africa, C aribbean and part South America) with mate to female 1/1.] Thirty-one subjects (24%) were aware that their partners had participated in bise xual activity. Only six subjects perceived themselves at risk through their own or partner's drug injecting activity. The frequency of risk factors was substantially greater than that ascertained by the routine history. The findings highlight the potential risk of heterosexual sp read resulting from travel to or residence in high prevalence territor ies. The contribution by male partners is significant and is particula rly difficult to detect during a routine interview. These data support the recommendation that voluntary HN serum testing should be universa l rather than a selective offer based on risk factors determined at a routine history.