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Canadian Journal of Infectious Diseases and Medical Microbiology
Volume 17, Issue 4, Pages 224-228
Original Articles

Prenatal Screening for HIV in Nova Scotia: Survey of Postpartum Women and Audit of Current Prenatal Screening Practices

Mark Downing,1 Laura Youden,1 Beth A Halperin,2,6 Heather Scott,3,6 Bruce Smith,4 and Scott A Halperin2,5,6

1Faculty of Medicine, Dalhousie University, Canada
2Department of Pediatrics, Dalhousie University, Canada
3Department of Obstetrics and Gynecology, Dalhousie University, Canada
4Department of Mathematics and Statistics, Dalhousie University, Canada
5Department of Microbiology and Immunology, Dalhousie University, Canada
6IWK Health Centre, Halifax, Nova Scotia, Canada

Received 16 March 2006; Accepted 19 June 2006

Copyright © 2006 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


BACKGROUND: Current guidelines for screening for HIV infections in Nova Scotia recommend an opt-in approach in which patients are counselled and consent to testing. The objectives of the present study were to measure adherence to these recommendations, to explore women's knowledge, attitudes, beliefs and behaviours concerning HIV screening, and to compare these results with prenatal screening practices for rubella, hepatitis B and group B streptococcus.

METHODS: All women who gave birth consecutively during a seven-week period were recruited. Study participants were interviewed to determine their knowledge, attitudes and beliefs concerning prenatal screening. Hospital and laboratory records were reviewed for information concerning prenatal screening and perinatal treatment to audit screening practices.

RESULTS: A total of 279 patients were enrolled in the study, representing 58% of those eligible. The HIV screening rate was 72%, compared with 95% for rubella, 89% for hepatitis B and 24% for group B streptococcus. Of the participants tested for HIV, 80% were aware of being tested. Of all the study participants, 17% indicated having received pretest counselling about HIV, 56% volunteered to be tested for HIV, 78% received the test results, and 3.8% received post-test counselling. More participants preferred an opt-out approach to HIV screening (50%), where testing is routinely performed on everyone, rather than the opt-in approach (43%). Participants displayed a similar preference for screening for the other infections.

INTERPRETATION: HIV prenatal testing rates in Nova Scotia are comparable with those of other provinces that recommend an opt-in approach, but are lower than testing rates for opt-out programs. Most study participants were not screened using the recommended opt-in approach.