Screening of pregnant women for HIV
19 October 2004
Screening of pregnant women for HIV should begin as soon as possible
The number of children becoming infected with HIV at or around the time of birth in New Zealand is a tragedy that can be prevented if a national HIV screening programme for pregnant women is made available as soon as possible, the New Zealand AIDS Foundation says.
The Foundation has welcomed news that the National Health Committee is recommending a trial of HIV screening with a pilot programme for all pregnant women in Auckland, but says the record number of five children infected with HIV at or around the time of birth in New Zealand in 2003 is evidence that the service should be made available to all pregnant women.
“There is very good evidence,” says NZAF Executive Director Rachael Le Mesurier, “that early detection of HIV in pregnant women means that procedures can be put in place – including HIV medication for the mother and a caesarean birth – to reduce the chances of the child becoming HIV positive to almost zero.”
Ms Le Mesurier says while an Auckland trial would be welcome, the NZ AIDS Foundation is concerned that NHC proposal means it could still be two years before a decision for a national HIV pregnancy screening programme is made, an unnecessary delay when initial guidelines for HIV testing of pregnant women were developed back in 1997 and were said at the time to be “interim” because more information was expected.
“It would be a shame on our reputation as world leaders in HIV prevention if more children become HIV positive, and more mothers remain unaware of ways to prolong their own lives, because it has taken so long to trial universal screening. We already have information that supports the concept.
“Countries such as the United Kingdom, Canada and the Netherlands have discarded ‘targeted communities’ screening (for example, offering HIV tests to women who are or were, intravenous drug users or their partners were) as inefficient. They have adopted universal screening with informed consent and opt-out policies. “Further, a recent survey conducted in New Zealand supports the anecdotal experience that the majority of pregnant New Zealand women would welcome HIV screening, indeed many of them think it is already part of the blood tests offered”
The New Zealand Foundation calls for the screening pilot to start promptly and to have a review every six months to ensure there is no unnecessary delay between New Zealand-based evidence of success and moving to national HIV screening being offered to all pregnant women as quickly as possible.