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Issues to consider about HIV testing during pregnancy
| Last updated: 18.06.04 |
All HIV testing should be in the best interests of the person targeted. In considering a test during pregnancy, the following guidelines might be useful
- What prior knowledge of HIV does the woman have? Many people believe that all babies born to HIV positive women will be HIV-positive too. This false assumption can be a disincentive to testing. It is important that women realise there could be medical benefits to themselves as women in their own right
- Has the woman had a test previously?
- What are the risk factors involved – sexual partners, past or current IDU, blood transfusions?
- Does the woman/couple understand the significance of the window period?
- Does the woman/couple understand that discordant results between partners are common?
- What are the benefits of testing – reassurance if HIV negative, preparation and intervention possibilities if HIV positive, benefits for woman as person in her own right, as well as risk reduction for vertical transmission, health education opportunities?
- What are the disadvantages – impact on the woman, relationship, family, friends, work?
- Does the woman understand the potential problems with mortgages and life insurance if found to be HIV-positive? Does she realise that the insurance industry no longer penalises a woman who is tested as part of antenatal screening (as long as she is found to be HIV-negative)?
- Does the woman/couple know about safer sex/safer drug use during pregnancy?
It is also particularly important to recognise that the majority of women infected with HIV in this country are from sub-Saharan Africa. The pre–test discussion must be culturally appropriate. Antenatal screening is not common in parts of Africa, but more importantly the stigma of HIV is very great. For many African women, their immigration status, housing and social problems may seem more pressing than health concerns. The idea of HIV testing in pregnancy may be totally alien.