By LISA PENNEY
Vancouver -- Re HIV Tests Urged For Pregnancies (July 15): There are a number of conditions other than HIV, including pregnancy itself, that can cause a woman to test positive to an HIV test. The fact that 90 per cent of women testing positive were not in a high-risk group gives weight to the possibility that many of these are false positives. False positives are resulting in newborns being needlessly treated with AZT, a toxic drug that has caused ill health and death in children. A mother with a positive HIV result also usually ends up not breastfeeding, which can deprive her child of the immunity needed for lifelong health.
HIV tests urged for pregnancies
By BRIAN LAGHI
OTTAWA -- Government AIDS authorities are recommending that doctors begin offering routine HIV tests to all their pregnant patients amid studies that show many women are unaware of their partners' past behaviour. The recommendations are part of a series of guidelines released this month by an intergovernmental advisory committee on AIDS and published in the federal government's monthly report on communicable diseases. The report says tests should be offered to every pregnant woman as a matter of course because of the difficulties in assessing the risks pregnant women are exposed to through their partners. "Some women are exposed to risk factors that health-care providers may not be aware of," the report says. "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." Nina Arron, a federal official on the committee, said doctors should begin speaking directly to their pregnant patients about the availability of tests and offer patients the examination if they want it. Ms. Arron explained that Canada's provinces and territories have different policies for offering HIV tests to pregnant women. Some for example, offer routine HIV tests to all pregnant women and others perform the tests unless they are told specifically not to by the patient. In other jurisdictions, however, HIV tests are offered only to pregnant women considered high risk. "What this document is saying is that the preferred option is that it should be part of a routine prenatal screening and women should be informed and have the opportunity to have an informed choice," Ms. Arron said. The report's recommendations are based on studies which found many women are not aware of their own risk for HIV. For example, one study of HIV-positive women found that 90 per cent had no perception of risk before testing positive, while another suggested that many women who believe they are in a monogamous relationship are actually at risk due to their partner's past or continuing activity. Testing pregnant women has become particularly important over the past decade because of the discovery that the anti-AIDS drug AZT is effective in reducing the rate of transmission within the womb. "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." Other guidelines say that tests should be voluntary and that a doctor should receive informed consent from the patient. Although the guidelines are not mandatory, Ms. Arron said she hopes that their publication will have an educational effect on doctors, women's groups, patients and other medical professionals. "Putting a document out like this you would hope will increase awareness of the issue, one would think. The more women that are tested, the better." The publication of the document may also prompt women to ask for the tests, Ms. Arron said. The federal Health Department found that 138 infants tested positively for HIV in 2001, although the survey only included women who were HIV positive. That number was up slightly from 126 cases the year before. There have been 1,384 such cases since 1990. Ms. Arron said she is not sure if there are any parts of the country in which pregnant women must ask for the test. Although governments had established guiding principles for the availability of AIDS testing for the general population, it had not done so for pregnant women.
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