A recently conducted in-depth review of antenatal HIV screening in Glasgow's maternity hospitals has shown the programme is dramatically cutting HIV infection risks for babies.
The review, carried out by NHS Greater Glasgow and Clyde's Public Health Protection Unit, spanned a 17 month period between 1 August 2003 and 30 April 2005 and evaluated the effectiveness of the HIV screening programme for pregnant women.
During the review 20,006 women attended for antenatal care of whom 94% accepted an HIV test.Thirteen of these women had HIV positive test results.However, only two of them actually knew of their HIV status; the remaining 11 would have continued their pregnancies without receiving the benefits of highly effective treatment to prevent transmission of HIV to their baby.
Without treatment, the average risk of a pregnant HIV positive woman passing HIV to her baby is about 15%, but modern treatments have cut this transmission risk to less than 1%. However, people may carry HIV infection for years with no symptoms and unless a woman realises that she is HIV positive, neither she nor her baby can benefit from this life-saving treatment.
Public Health Specialist Registrar Dr Anne Scoular, who conducted the review, said:
"The review evaluated numerous aspects of the programme, including how effectively it detected HIV positive women, the quality of the care they received after diagnosis and what women and their health professionals thought about pregnant women being routinely offered an HIV test. It also examined the programme's costs relative to the health gains it achieved.
"By identifying HIV positive women who will benefit from effective, modern treatments for HIV in pregnancy, this screening programme transforms a 15% risk of mother to baby transmission to almost zero."
The programme successfully identified virtually all of the HIV positive women who received maternity care during the review period. By comparing the number of HIV positive women identified by the programme with figures from a longstanding anonymous testing programme among newborn babies, this analysis showed that In 2002 (the year before the programme was introduced), eight HIV positive women gave birth in Glasgow hospitals - however, six of these women remained undiagnosed. In contrast, by 2004-5, after the screening programme had become established in Glasgow, eight HIV positive women gave birth during the last year covered by the review had detected by the screening programme.
Dr Scoular added: "This programme has proved to be highly effective in identifying virtually all HIV positive women who attend Glasgow's maternity hospitals. This has been a highly effective and successful screening programme. The evaluation suggests that approximately 8 HIV positive women every year in Glasgow would have remained undiagnosed if the programme did not exist, with a substantial risk of them passing the infection to their babies. Now these women have the chance to receive lifesaving treatments both for themselves and can also prevent their babies from becoming infected. In addition, many thousands of women with negative test results gain peace of mind".
Notes to Editors
Since July 2003, every pregnant woman in Glasgow has been routinely offered an HIV test at her antenatal clinic appointment. The programme was introduced to allow women who are HIV positive to benefit from new treatments that dramatically reduce mother-to-child HIV transmission.
Since the evaluation period ended, another nine women have subsequently been identified as positive bringing the total to 22 from the launch of the programme.
Surveys of women attending antenatal clinics revealed that virtually all were pleased to be offered a test and most found it easy to make the decision to be tested.
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