THE CONSEQUENCES OF A POSITIVE PRENATAL HIV ANTIBODY-TEST FOR WOMEN

As more women of childbearing age are affected by the human immunodefi ciency virus (HIV), many providers have demanded routine perinatal HIV screening, arguing that the medical benefits of testing outweigh the socioeconomic, medical, and psychological risks of a positive HIV test for women. In this primarily urban poor population, we used a semistr uctured interview to evaluate differences in health care discriminatio n, economic losses, risk behaviors, relationships changes, and psychol ogical status in 20 HIV-positive and 20 HIV-negative mothers matched f or HIV risk, race, income, and delivery date. Many (35%) seropositive and no seronegative women cited health care discrimination due to HIV status. Although seropositive women reported greater satisfaction with social support from friends (100%) and family (80%), many women had n ot disclosed their HIV status to any friends (65%) or family (25%), in dicating fear of abandonment. Only 56% of HIV positive and 44% of sero negative women knew their partners' HIV status, and many HIV-positive and HIV-negative women reported having sex without condoms after the H IV test. Mean standardized anxiety (p < 0.05) and depression scores we re higher in seropositive women. Despite added social support and medi cal treatments, HIV-positive women showed higher levels of health care discrimination, personal isolation, and psychological sequelae than t heir seronegative counterparts. As the medical benefits to prenatal HI V testing increase, we will need to develop focused medical, social, a nd mental hearth services addressing the needs of HIV-positive women.