Prenatal HIV screening in a tertiary care centre.

OBJECTIVE Strategies are available to reduce maternal-fetal transmission of HIV and depend on adequate prenatal screening. At present, a significant proportion of Canadian pregnant women remain unscreened. We reviewed our screening practices before and after the implementation of a departmental policy on universal counselling for HIV screening and the distribution of a patient educational brochure developed at our centre (interventions). METHODS Charts of all new antenatal patients seen during February-April in 1996 (n = 186) and 1998 (n = 212) were reviewed. Maternal demographics and evidence of HIV counselling and screening were collected and analyzed. RESULTS Following our interventions, HIV counselling and screening rates increased from 13% to 72%. Patient acceptance of testing was high. The majority of missed opportunities for HIV testing were patients transferred urgently from other institutions. CONCLUSION HIV counselling and screening can be improved by implementation of local strategies. We have demonstrated the feasibility of this approach in a tertiary care unit.