WOMENS KNOWLEDGE AND ATTITUDES, AND THE ACCEPTABILITY OF VOLUNTARY ANTENATAL HIV TESTING

Objective To assess pregnant women's knowledge of, and attitudes towar ds, antenatal HIV testing, and its acceptability to them. Setting Ante natal clinic at Guy's Hospital, London, six community antenatal clinic s and a midwifery group practice. Population Eight hundred and forty-t hree women attending the antenatal clinics. Method The women received a leaflet explaining HIV testing, and completed a questionnaire before and after their booking appointment. This included an assessment of t heir knowledge of, and attitudes towards HIV testing, and its acceptab ility. Results Seven hundred and eighty-nine women (94%) completed que stionnaires. Fifty-one percent (n = 405) were Caucasian, 25% (n = 195) African, 11% (n = 86) West Indian and 13% (n = 100) were from other e thnic groups. Fifty-eight percent received the HIV information leaflet , of whom 86% had read it. Knowledge relating to HIV was good, the med ian knowledge score being 6 out of a possible 8, but it was less in no n-Caucasian women and those with fewer educational qualifications. Kno wledge was not related to uptake of testing. Thirty-five percent of wo men accepted the offer of an HIV test, rates being higher in hospital clinics (41%) than in the midwifery group practice (10%) and the commu nity clinics (30%). Women more likely to accept the offer of an HIV te st were non-Caucasian (P = 0.0443), those who had thought about the HI V test before this pregnancy (P = 0.0298) and those seeing one particu lar midwife (P = 0.0003). Most women (67%) thought that all pregnant w omen should be offered the HIV test and then make their own decision. Overall, 64% women did not change their original pre-discussion decisi on on testing for HIV. Thirty-six percent of women changed their decis ion from 'yes' to 'no' or 'don't know' after seeing the midwife. Women attending the community clinics (P = 0.003) and those who had been te sted before (P = 0.0451) were more likely to change their decision. Co nclusion This study, in a multiethnic population, has shown that knowl edge regarding HIV is good but does not increase the uptake of testing . Women prefer to be offered the HIV test and make their own choice re garding whether to accept it.