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Is HIV testing in antenatal clinics worthwhile? Can we afford it?

Since 0.2-0.4% of pregnant women attending antenatal clinics (ANC) at St Thomas's Hospital are HIV positive, and as the Department of Health (DH) have recommended that universal voluntary HIV testing be made available to women attending ANC in areas of 'known or suspected higher prevalence of HIV in...

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Published in:AIDS Care Vol. 7; no. 2; pp. 135 - 146
Main Authors: Chrystie IL, Zander L, Tilzey A, Wolfe CD, Kenney A, Banatvala JE
Format: Journal Article
Published: Taylor & Francis Ltd Apr95
Online Access:View this record in EBSCOhost
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      dt: Apr95
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      pub: Taylor & Francis Ltd
      place: Philadelphia, Pennsylvania
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        atl: Is HIV testing in antenatal clinics worthwhile? Can we afford it?
      aug:
        au:
          Chrystie IL
          Zander L
          Tilzey A
          Wolfe CD
          Kenney A
          Banatvala JE
        affil: Department of Virology, United Medical School of Guy's and St Thomas's, London, UK.
      sug:
        subj:
          AIDS Serodiagnosis Economics
          Health Care Costs
          Prenatal Care Economics
          Consent
          Cost Benefit Analysis
          Cost Control
          Counseling Economics
          Europe
          Female
          Financing, Government
          Health and Welfare Planning
          Outpatient Service
          Patient Attitudes
          Pregnancy
          Female
      ab: Since 0.2-0.4% of pregnant women attending antenatal clinics (ANC) at St Thomas's Hospital are HIV positive, and as the Department of Health (DH) have recommended that universal voluntary HIV testing be made available to women attending ANC in areas of 'known or suspected higher prevalence of HIV infection', we examined the implications of the DH initiative in an Inner London Teaching Hospital as well as in a General Practice involved in shared care. The cost of the programme (148,300 pounds to 193,900 pounds), 80% of which relates to the need to obtain informed consent, was approximately 2.7-3.5 times that calculated by the DH. The DH based much of their costing on additional time for counselling rather than calculating the additional staff required. We estimated that 25% of women will require specialized counselling since 17% are of African ethnicity and others are injecting drug users or 'worried well'. Various means of reducing costs were considered but, until such time as explicit, informed consent is no longer considered necessary, the above resources will be required. Unless the DH continues to provide central direction to Providing Agencies to give priority to these recommendations and, where necessary, provides additional funding, we fear that this important public health initiative will be unsuccessful.
      pubtype: Academic Journal
      doctype: Journal Article
      ougenre: Article
    language: English
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