HIV TESTING AND PREVALENCE IN PREGNANCY IN EDINBURGH

The objective was to study the changes in pregnancy HIV prevalence wit h time. Data were collected from multiple sources to provide a compreh ensive record of all HIV seropositive pregnant women identified in the Edinburgh area (Scotland) until December 1992. There were 177 pregnan cies in 108 HIV seropositive identified women. Risk factors were injec tion drug use (79% of pregnancies) and a known HIV seropositive inject ion drug-using partner (16%). Prevalence has decreased for Edinburgh C ity women from 0.5% of all pregnancies in 1986 to 0.1% in 1992; It was higher for induced abortion (0.6%) than for delivery (0.2%). HIV test ing in pregnancy has declined. Comparison with unlinked anonymized tes ting showed that in 1990-1991, 20/22 seropositive women were known. In 1992, only 3 of 10 seropositive pregnancies were identified. The coho rt initially infected by exposure to a 'drug related' risk factor betw een 1983 and 1985 may have increasingly finished childbearing, deliber ately decided against pregnancy because of HIV status, and declined be cause of death, illness and emigration from the area, There may not ha ve been major early tertiary heterosexual spread; however, data from 1 992 suggest that this could now be impacting on pregnancy prevalence. Local testing policies have not adapted to this possible change.