Human immunodeficiency virus infection in women attending an inner-city prenatal clinic: ineffectiveness of targeted screening

Article Abstract:

The heterosexual spread of acquired immunodeficiency syndrome (AIDS) is increasing in Europe and North America. A consequence of this trend is an increase in human immunodeficiency virus (HIV) infections in newborns. In some areas of the US, as many as 2 percent of live births occur in AIDS-infected mothers. In an effort to reduce this statistic, HIV testing of women identified as high risk for AIDS is recommended by the Centers for Disease Control (CDC) and the American College of Obstetricians and Gynecologists (ACOG). Current efforts are concentrated on counselling and testing high-risk women during their pregnancy. To assess the impact of the CDC and ACOG guidelines, women who were registered at an inner-city clinic between February 1987 and August 1988 were enrolled in the study. Each woman completed a questionnaire designed to obtain demographic data and to assess risk behavior for HIV infection. Those whose answers suggested high-risk were offered HIV testing. Testing was available, but not routinely offered to patients who were not considered high-risk. A total of 1,060 women were evaluated; of these, 198 acknowledged high-risk behavior and 862 did not. Thirty women tested positive, including 14 (47 percent) who did not acknowledge high-risk behavior. Limiting prenatal HIV testing only to those who acknowledge high-risk behavior, may fail to identify a substantial number of infected women. Screening should be offered to all pregnant women. This screening should include HIV testing, as well as counselling and education on risk reduction procedures. Specific targeted screening appears to be ineffective in identifying HIV infection. (Consumer Summary produced by Reliance Medical Information, Inc.)

Testing, Risk factors, Pregnancy, AIDS (Disease) in pregnancy

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Every person infected with HIV-1 should be in a lifelong early intervention program

Article Abstract:

Enrolling HIV-infected people in public health programs that focus on preventing further HIV transmission may save public money in the long run. Public health programs that include HIV testing and identification of HIV-positive individuals have been resisted by AIDS activists. The federal government lacked the money and political consensus to promote long-term AIDS prevention programs. The government could save money on AIDS medical care if prevention programs were created for HIV-infected people and their partners. AIDS activists and the government should work together to provide long-term medical and preventive care for the HIV-infected.

Care and treatment, Editorial, Political aspects, HIV patients

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Evaluating AIDS Prevention Interventions Using Behavioral and Biological Outcome Measures

Article Abstract:

Behavioral and biological outcomes can be used to evaluate interventions designed to change people's behavior. Behavior can be assessed using the patient's self-report. Very sensitive tests are also available to diagnose sexually transmitted diseases (STDs). Neither method should be used alone. Behavioral changes are critical in preventing many STDs, especially HIV infection.

Evaluation, Behavioral assessment

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