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Antenatal HIV testing: assessment of a routine voluntary approach

BMJ 1999; 318 doi: (Published 19 June 1999) Cite this as: BMJ 1999;318:1660
  1. Wendy M Simpson, research psychologist (,
  2. Frank D Johnstone, consultant obstetrician and senior lecturera,
  3. David J Goldberg, deputy directorb,
  4. Siobhan M Gormley, research midwifea,
  5. Graham J Hart, assistant directorc
  1. aDepartment of Obstetrics and Gynaecology, Centre for Reproductive Biology, University of Edinburgh, Edinburgh EH3 9EW
  2. bScottish Centre for Infection and Environmental Health, Clifton House, Glasgow G3 7LN
  3. cMRC Medical Sociology Unit, University of Glasgow, Glasgow G12 8RZ
  1. Correspondence to: Dr W M Simpson, 22 Lumsden Park, Cupar, Fife KY15 5YL

    Papers pp 16501656

    The benefits of testing pregnant women for HIV are increasingly assured, particularly with regard to reducing vertical transmission.1 Yet uptake of antenatal HIV testing in Britain remains low.2 Our previous study examined an opt-in approach (women had to make an active choice to be tested).3 Some women were uncomfortable with this, feeling that it indicated high risk behaviour. We therefore assessed an approach based on similar requirements for information and consent but with a change in emphasis, in that testing was routine unless the woman declined.

    Subjects, methods, and results

    The testing programme was conducted during February to April 1998. Before their booking appointment, all women were sent a leaflet about blood tests to be conducted, including HIV testing. At the antenatal clinic they were offered an HIV test by midwives who had been trained to use a printed discussion protocol that emphasised the benefits and presented the test as routine, making it clear that the woman could decline. As with the other blood …

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