Canada: Doctors Urged to Make HIV Tests Routine for Pregnant Patients

Canadian government AIDS authorities are recommending that doctors begin offering routine HIV tests to all their pregnant patients amid studies showing that many women are unaware of their partners' past behavior. "Some women are exposed to risk factors that health care providers may not be aware of," the report said. "Anecdotal and qualitative evidence suggests that women may be discouraged by their physician from testing for HIV because of a perceived absence of risk factors." The recommendations are included in guidelines published in the July 1 issue of the Canadian Communicable Disease Report (2002;28;13).

Federal official Nina Arron said that Canada's provinces and territories have different policies for offering HIV tests to pregnant women. Some offer routine HIV testing to all pregnant women, performing the test unless specifically told not to by the patient. Others offer the test only to women considered high-risk. "What this document is saying is that the preferred option is that it should be a part of a routine prenatal screening and women should be informed and have the opportunity to make an informed choice," Arron said.

The recommendations are based on studies showing that many women are not aware of their HIV risk. One study of HIV-positive pregnant women found that 90 percent had no perception of risk before testing positive, while another suggested that many women who believe they are in a monogamous relationship are at risk due to past or current risk behavior by their partner.

"Current testing technology and treatment options have made it possible to prevent virtually all mother-to-child transmission of HIV," the report said. "Therefore, the identification and appropriate management of HIV infection in pregnancy is tremendously important."

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