Use of anonymous newborn serosurveys to evaluate antenatal HIV screening programmes.
OBJECTIVE
To evaluate the extent to which antenatal HIV screening programmes identify HIV infected women who go to term.


METHODS
Comparison of results of two surveillance systems. An anonymous neonatal HIV serosurvey was used to estimate the numbers of HIV infected women giving birth; reporting by obstetricians was used to assess the proportion who had been identified.


METHODS
Three Thames regions.


RESULTS
729,105 neonatal blood samples were tested, of which 484 were HIV seropositive. Newborn HIV seroprevalence is increasing, at different rates, in inner London, suburban London, and in non-metropolitan districts. During the past four years the proportion of infected women who have been identified before delivery is 16.9%, but less than half of these were diagnosed during pregnancy. In 1993 only five of the 128 (4%) previously undiagnosed infected women delivering babies were identified by antenatal screening.


CONCLUSIONS
Despite increased emphasis on antenatal testing for HIV in areas of higher prevalence the number of undiagnosed women delivering babies continues to increase. Consideration should be given to alternative strategies for offering antenatal HIV testing. Antenatal screening programmes should be monitored continuously by comparing anonymous neonatal seroprevalence with clinical reports from obstetricians.
Holland
F J
FJ
Department of Epidemiology and Biostatistics, Institute of Child Health, London, United Kingdom.
Ades
A E
AE
Davison
C F
CF
Parker
S
S
Berry
T
T
Hjelm
M
M
Wilcox
A H
AH
Cubitt
D
D
Hudson
C N
CN
Peckham
C S
CS
D016001:Confidence Intervals; D004739:England / Q000453:epidemiology; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000517:prevention & control*; D006679:HIV Seropositivity / Q000175:diagnosis; D015528:HIV Seroprevalence; D015497:HIV-1; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control* / Q000706:statistics & numerical data; D008131:London / Q000453:epidemiology; D008403:Mass Screening; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis / Q000517:prevention & control*; D011295:Prenatal Care; D015203:Reproducibility of Results