HIV testing and prevention issues for women attending termination assessment clinics

Abstract

The prevalence of HIV infection in London is nearly threefold in women who seek terminations compared to women who carry to term. Despite the higher prevalence, HIV testing is not systematically offered to women attending termination of pregnancy assessment clinics (TOPCs). The Department of Health has given clear guidance on HIV testing in antenatal clinics and most London antenatal clinics have implemented policies on HIV testing. No similar guidance exists for TOP clinics. This paper describes the results from a study examining HIV testing and prevention issues for women attending five TOPCs in North London. Data on risk disclosure, HIV testing intentions and awareness of HIV infection and testing were analysed for 141 women who completed a self-administered questionnaire. Women who expressed an intention to have an HIV test were more likely to be from ethnic minority origin, to report that their partner intends to have an HIV test and to perceive it as easier to talk to their partner about HIV testing, compared to women who did not report an intention to test for HIV The former group also were more likely to have had a previous HIV test and perceived their personal control for staying HIV negative as greater compared to others. Fifty six (39.8 per cent) women disclosed one or more potential risk factors for HIV Women with risks were more knowledgeable about HIV infection, perceived their personal chances of being HIV positive as greater and experienced greater worry about past risks, compared to women who disclosed no risks. However, women who disclosed risk factors were no more likely to intend to have an HIV test. Knowledge on HIV infection, testing and potential interventions to reduce mother-to-baby transmission was low, with fewer than one in four women being aware that transmission may be reduced by AZT, Caesarean section and bottle feeding. Given the findings about the level of risk disclosed and women's positive attitude towards information on HIV infection and testing, this client group should no longer be overlooked in the planning of future policies on HIV testing for populations at risk.

PIP: In London, women who seek induced abortions have a level of HIV seroprevalence almost 3 times higher than do women who carry their pregnancies to term. However, despite this higher prevalence, HIV testing is not systematically offered to women attending termination of pregnancy assessment clinics (TOPCs). This paper examines results from a study of HIV testing and prevention issues for women attending 5 TOPCs in North London. Data on risk disclosure, HIV testing intentions, and awareness of HIV infection and testing were analyzed for 141 women who completed a self-administered questionnaire. Women who expressed an intention to have an HIV test were more likely to be of ethnic minority origin, to report that their partner intends to have an HIV test, and to perceive it as easier to talk to their partner about HIV testing, compared to women who reported no intention to test for HIV. The former group was also more likely to have had a previous HIV test and felt better able to remain HIV negative. 39.8% of women disclosed 1 or more potential risk factors for HIV. However, although women with risks were more knowledgeable about HIV and had a stronger sense of their potential HIV infection, they were no more likely than women who disclosed no risks to have an HIV test. Less than 25% knew that the risk of mother-to-child HIV transmission can be reduced through AZT therapy, cesarean section, and bottle feeding.