EVALUATION OF AN ANTENATAL HIV TESTING PROGRAM IN AN INNER LONDON HEALTH DISTRICT

Objective To study an antenatal human immunodeficiency virus (HIV) tes ting programme in an inner London health district. Design A standardis ed research interview was given to women in the first half of pregnanc y and the findings were compared with those of the routine clinical in terview. The observations were analysed in relation to the results of HIV antibody testing, either attributable by consent or anonymously, i n these women. Setting The Homerton Hospital, London. Subjects Three t housand seven hundred and twenty-nine women, of whom 1696 (45.5%) cons ented to testing. Results Four women who had consented to testing had a positive result. Amongst the 2033 women (54.5 %) who declined the te st, four (or five) had a positive result. The number of risk factors a scertained by the research study interview was substantially greater t han that elicited by the preceding routine interview. In addition, mor e information was obtained by a routine computer interview than by its unstructured equivalent. There was no obvious association between the presence of a risk factor and whether or not the women had consented to the test. Conclusions Our formal voluntary testing programme detect ed nearly 44% of HIV seropositive individuals. Thus, there were four k nown positives during the study period against a total of nine detecte d by anonymous testing. Since all the known positive results in the st udy were associated with recognised risk factors, there is some doubt as to the value of a universal testing programme. However, if testing is to be based upon the existence of a risk factor elicited at the boo king history, then the deficiencies in this history revealed by the pr esent study need to be corrected.