Routine Screening for HIV Infection in Booked Antenatal Women: How Justified in Developing Countries?

Abstract

Infection with the HIV has become a pandemic and has posed a great health problem both in developed and developing countries. In response to the above most developed countries offer routine screening to all pregnant women and to test them for HIV after counseling and obtaining informed consent. In developing countries this approach has also been suggested but has not been seriously implemented. Following the increasing incidence of HIV infection throughout the world a policy of routine HIV screening for pregnant women was adopted in the obstetric department of the University of Nigeria Teaching Hospital Enugu Nigeria in the latter part of 1998. In a retrospective analysis of the antenatal records of 600 women 234 (39%) failed to have the HIV test performed even when they had consented to it. Some of the reasons for non-testing include the high cost of routine screening and lack of structure for taking care of HIV positive pregnant mothers and their babies. In this regard developing countries should emphasize on prevention through education information and communication. Health education campaigns should be intensified as well as prevention and treatment of sexually transmitted diseases changes in behavioral patterns of the people promotion of barrier methods of contraception and the practice of monogamous faithful relationships. These cost-effective interventions are worth exploring in resource poor countries; governments and other health care providers are called upon to make this a priority.