Editorials

Antenatal HIV testing

The advantages of ascertaining a pregnant woman's HIV positive status before delivery are clear: transmission to the baby can be roughly halved by avoiding breast feeding¹ and reduced by a further two thirds by the administration of zidovudine.² Yet, as several papers in this week's issue show, in Britain we are failing to test pregnant women for HIV and, as a result, to reduce the rate of vertical transmission.

Undoubtedly there are psychological and social disadvantages to a woman in discovering that she is HIV positive, but these will inevitably occur at some time. The advantages of knowing are particularly great in pregnancy. As well as through avoiding breast feeding and using zidovudine, further reductions in the risk of transmission may be possible by offering caesarean section,³ using other antiretrovirals, and avoiding invasive procedures during vaginal delivery. The paper by Lyall et al shows that women will take these measures . . . [Full text of this article]

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Relevant Article

Reducing the vertical transmission of HIV

Babatunde A Gbolade, K H Tan, K P Teo, Ben Essex, Mary A Waldron, Elizabeth Foley, V Harindra, Meg Goodman, Adeola Olaitan, Sara Madge, Melvyn Jones, Margaret Johnson, Fabio Parazzini, Elena Ricci, Paola Grasso, Matteo Surace, Guido Benzi, and Paquita de Zulueta
BMJ 1998 316: 1899. [Extract] [Full Text] [PDF]

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• de Zulueta, P. (2000). The ethics of anonymised HIV testing of pregnant women: a reappraisal. J. Med. Ethics 26: 16-21 [Abstract] [Full text]  
• Postma, M J, Beck, E J, Mandalia, S, Sherr, L, Walters, M D S, Houweling, H, Jager, J C (1999). Universal HIV screening of pregnant women in England: cost effectiveness analysis. BMJ 318: 1656-1660 [Abstract] [Full text]  
• Gbolade, B. A, Tan, K H, Teo, K P, Essex, B., Waldron, M. A, Foley, E., Harindra, V, Goodman, M., Olaitan, A., Madge, S., Jones, M., Johnson, M., Parazzini, F., Ricci, E., Grasso, P., Surace, M., Benzi, G., de Zulueta, P. (1998). Reducing the vertical transmission of HIV. BMJ 316: 1899-1899 [Full text]