Screening for human immunodeficiency virus in gynecologic and obstetric patients: Does it make sense?

Objective: To discuss the possible benefits and shortcomings of routine scr eening for HIV in gynecologic and obstetric patients. Method: Literature review. Results: The prevalence of HIV infection in Western Europe is low (0.23%). Epidemiologic data from Austria for the year 1999 show that 74% of all newl y diagnosed cases of HIV infection in women occur at an age of 20 to 40 yea rs and only 4% at an age of more than 50 years. Perinatal vertical transmis sion of HIV from mother to child can be reduced from about 30% to less than 1% by antiretroviral therapy, elective cesarean section, prophylactic ther apy of the newborn and avoiding breast-feeding. Thus, the data support scre ening all pregnant women for HIV infection. The risk of hospital staff for occupational HIV infection is low compared to other blood-borne infections such as hepatitis B or C. Universal precautions for dealing with body fluid s should be observed. Screening gynecologic patients for HIV is not an appr opriate measure to reduce the risk of occupational HIV infection. Conclusions: Because vertical transmission can be prevented, all pregnant w omen should be screened for HIV infection. In contrast, it makes little sen se to screen all gynecologic patients.