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CMAJ
CMAJ - May 4, 1999JAMC - le 4 mai 1999

Compulsory HIV tests

CMAJ 1999;160:1286

See response from: D.M. Patrick, D. Burdge
Although I generally agree with David Patrick and colleagues' article on the routine offering of prenatal testing for HIV in a low-prevalence setting [abstract / résumé],1 I am concerned about their emphasis on potential cost savings. Surely an HIV test should be mandatory in antenatal care, just as the Wassermann reaction test has been. To "offer" it is not good enough if the test result may well foretell a serious outcome and result in active treatment that benefits both mother and child. HIV testing must be done regardless of cost and should be followed by appropriate counselling.

In my view, there should be no option for women to "exercise their informed choice as to whether the test should be performed." As doctors we are interested in reducing morbidity and preventing the spread of infection, even within the family. In such situations a degree of compulsion is sometimes necessary, even in a low-prevalence setting. There is too much at stake to forgo this test.

R. Walter Dunn, MB
South Surrey, BC

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Reference
  1. Patrick DM, Money DM, Forbes J, Dobson SRM, Rekart ML, Cook DA, et al. Routine prenatal screening for HIV in a low­prevalence setting. CMAJ 1998;159(8):942-7.