Routine antenatal HIV testing

BMJ 1999;319:1069 ( 16 October )

Letters

Routine antenatal HIV testing

Is justified in areas of low HIV prevalence

Is acceptable to women

Is justified in areas of low HIV prevalence

The first 150 words of the full text of this article appear below.

EDITOR $---$ The recent papers by Postma et al and Simpson et al highlight the difficult issues in establishing a policy to testfor HIV infection in antenatal clinics. ¹ ²

Postma et al's paper examines the cost effectiveness of universal, voluntary testing of pregnant women in England in termsof healthcare costs to the NHS. Although no cut off point at whichthe cost for each life year gained becomes acceptable has beendefined for England, a cut off point of around $50 000 is suggestedin the United States. They conclude that in areas of high prevalence,such as London, universal, voluntary antenatal screening of pregnantwomen is cost effective; how- ever, in areas of low prevalence,screening may not be justified in terms of costeffectiveness.

Screening for HIV infection in antenatal clinics fulfils most of Wilson and Junger's criteria as a good test.³ HIV infectioncan be asymptomatic; the . . . [Full text of this article]

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Universal HIV screening of pregnant women in England: cost effectiveness analysis: M J Postma, E J Beck, S Mandalia, L Sherr, M D S Walters, H Houweling, and J C Jager
BMJ 1999 318: 1656-1660. [Abstract] [Full Text] [PDF]

Antenatal HIV testing: assessment of a routine voluntary approach: Wendy M Simpson, Frank D Johnstone, David J Goldberg, Siobhan M Gormley, and Graham J Hart
BMJ 1999 318: 1660-1661. [Extract] [Full Text] [PDF]

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