Screening HIV in pregnancy: a survey of prenatal care patients.

backgroundWomen in Canada, as in the rest of the world, represent an increasing proportion of new HIV positive cases. In 2002, women accounted for 25% of all positive HIV tests reported in Canada; with the majority being in their childbearing years (15 to 39 years), perinatal transmission of HIV in Canada is cause for concern. Following the development of interventions that can effectively reduce vertical transmission rate, prenatal screening of HIV has become the first and most pivotal step in the prevention of mother-to-child HIV transmission. The purpose of this study was to assess how women's knowledge and attitudes regarding HIV and HIV screening in pregnancy influence screening rates.

methodA prospective anonymous survey of 231 women attending antenatal care clinics at a teaching university hospital or in a community clinic was conducted.

resultsIn general, pregnant women supported universal HIV screening in the prenatal period. Women who previously had been tested for HIV and who did not perceive that they were at risk for contracting HIV were more likely to decline HIV testing in their current pregnancy. Overall knowledge regarding HIV and its transmission is less than optimal, particularly among those women who declined HIV testing.

conclusionKnowledge gaps exist between women accepting and declining prenatal HIV screening, particularly relating to benefits of screening. These results suggest that efforts have to continue to be put into educating the public but also, importantly, into changing current attitudes.