ANTENATAL HIV ANTIBODY TESTING IN AUSTRALIA

Objective: To evaluate the role of voluntary antenatal testing in HIV surveillance and prevention by examining antenatal HIV antibody testin g practice and policy in Australia. Design: Cross-sectional study usin g a self-administered questionnaire. Subject and setting: Specialist o bstetricians and gynaecologists and general practitioners (GPs) affili ated with the Royal Australian College of Obstetricians and Gynaecolog ists and Australian public hospital antenatal clinics, August-November 1992. Main outcome measures: The percentage of public hospital antena tal clinics and specialist and GP obstetricians in Australian who test ed pregnant women for HIV antibody as part of their antenatal care, an d the proportion of pregnant women in Australian who had an antenatal HIV antibody test in the 1991-92 financial year. Results: Questionnair es concerning antenatal HIV antibody testing were completed by 90% (99 3/1108) of specialists, 87% (2134/2461) of GPs and 93% (215/230) of pu blic hospitals surveyed. Of the 706 specialists and 1503 GPs who repor ted that they were currently engaged in obstetric care, approximately 60% (430/706 and 935/1503, respectively) offered antenatal HIV testing either to all pregnant women or to selected groups at risk. There wer e significant differences in testing patterns between States and terri tories. For the 95 public hospitals with antenatal clinics, 81% (77) o ffered the HIV antibody test to all or selected groups of pregnant wom en; these percentages did not differ significantly between States and Territories. It was estimated that 25% of pregnant women seen by speci alists, 29% seen by GPs and 9% seen in public hospital clinics were te sted for HIV antibody as part of their antenatal care in 1991-92. Conc lusions: In Australian approximately one in five pregnant women were t ested for HIV antibody as part of their antenatal care in 1991-92. Vol untary HIV testing in pregnancy may provide unrepresentative data for measuring the prevalence of HIV infection in pregnant women.