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HIV remains one of the major causes of mortality and morbidity among women of reproductive age; given the risk of vertical transmission to the fetus, timely prevention, monitoring and management are imperative (Melaku et al. [2014]. Causes of death among females-investigating beyond maternal causes: A community-based longitudinal study. BMC Research Notes, 7(1), 629. https://doi.org/10.1186/1756-0500-7-629). Most HIV studies in Lebanon focus on men who have sex with men, people diagnosed with sexually transmitted infections, intravenous (IV) drug users, and people infected by blood transfusion products Ministry of Public Health [2017]. National AIDS Control Program in Lebanon. ; Shaheen [2014]. Around 3,750 HIV/AIDS cases in Lebanon. The Daily Star. ). We conducted a retrospective review of women who delivered at a tertiary academic hospital in Beirut between January 2016-Decemeber 2017 to assess prenatal HIV screening practices. In total, 1500 charts were randomly selected and reviewed: 137 (9%) women were screened for HIV, 2 (1.5%) tested positive. Odds rations were calculated for screening in relation to religion, parity, previous abortions, and mode of delivery: none were significant. No one was tested for Gonorrhoea and Chlamydia; 1250 (93.8%) were tested for Hepatitis B, 27 (1.9%) for Hepatitis C, 7 (0.5%) for HSV and, 74(5.3%) for Syphilis. Barriers to screening may include: Lack of consensus on mandated screening policy, HIV stigma, physician and patient prejudice and misconception of risk and, financial barriers as health insurance does not cover HIV screening. [ABSTRACT FROM AUTHOR]

Despite a dramatic decrease in vertical transmission of HIV in the developed world, maternal HIV infection acquired after negative prenatal screening still leaves a window of vulnerability. Through quality assurance programs in two Canadian Provinces, five cases where perinatal HIV transmission occurred despite negative prenatal screening were identified between 2005 and 2015. Maternal risk factors such as intravenous drug use, high-risk sexual behavior, hepatitis C virus co-infection, and belonging to high prevalence minority groups were common. Two mothers had their negative HIV test performed in the first trimester and three mothers had negative testing in the third trimester. All babies were clinically healthy at delivery with a normal weight. Three babies were tested following subsequent identification of maternal HIV infection and two babies presented with opportunistic infections leading to their diagnoses. The characteristics of these cases suggest that to achieve complete elimination of vertical HIV transmission, selective and innovative clinical management of mothers at high risk for HIV may be required. [ABSTRACT FROM AUTHOR]

The object of this study was to assess the resource use, feasibility, uptake and consumers' perspective of introducing routine named human immunodeficiency virus (HIV) testing into an inner city hospital antenatal clinic (St Thomas Hospital, part of Guy's and St Thomas Hospital Trust). Following the introduction of a new service offering routine named HIV testing at booking appointments, the length of the appointments were recorded over a three-month period and compared with appointment lengths in the previously existing service. Women being offered routine named HIV testing were asked to complete a questionnaire before and after their appointment to assess knowledge, attitudes and acceptability of HIV testing. Subjects were three-hundred-and-eighty-one pregnant women attending the antenatal clinic for their booking appointment. There was no significant difference in the length of the booking appointments following the introduction of offering routine named HIV testing. One-hundred-and-fifty-eight women (42%) consented to testing with no positive results detected. There was a significant rise in the uptake of the test over the three-month period. No other variables (demographics, perceived risk, having read the leaflet) were predictive of uptake. Anxiety scores were significantly less after the booking appointment. Routine named HIV testing was feasibly introduced into a hospital antenatal clinic with minimum resource implications. Further study is needed to monitor the ongoing uptake rate and identification of HIV-positive women before a decision can be made as to the long-term benefit of this new service. Women considered it acceptable to be offered the HIV test and were less anxious after their appointments. [ABSTRACT FROM AUTHOR]

The objective of this study was to audit an ante-natal HIV screening programme by observing the congruence of documentation of consent between case notes and request forms; correlation of testing with prior agreement to be tested; and recording documentation that the test had been offered but declined in women who were not tested. The design was one of retrospective case note review of 538 women drawn from an inner city teaching hospital. There was documentation of invitation to undergo HIV testing in 415 (77%) cases. Test documentation was absent in 123 (23%) cases which represent 37% of those for whom a test was not performed. HIV testing was performed in 205 (38%) cases. There was discrepancy between documentation of consent to testing on the laboratory request form and in the notes. Some blood specimens of women agreeing to be tested were apparently never received in the laboratory. Incomplete documentation and a low test uptake suggests a low acceptance. However, without adequate documentation it cannot be determined in those not tested whether the test was declined or whether the invitation was either never extended, or not implemented after acceptance. Audit of implementation and staff compliance should be established at the outset of any universal testing programme. [ABSTRACT FROM AUTHOR]

Investigates the effectiveness of the British Department of Health's directive to make HIV antibody testing available to antenatal clinics. Cost of the directive; Need to provide specialized counselling to pregnant women.

Comments on the article `Is HIV testing in antenatal clinics worthwhile? Can we afford it?' by I.L. Chrystie et al from the journal `AIDS Care.' Logistics needed in a government-sponsored HIV antibody testing in Great Britain; Role of the Department of Health; Long-range effects of antenatal testing.