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  Universal Antenatal HIV Testing - the Concern of an Expectant Mother

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The Aim of Antenatal Check-up The aim of an antenatal check-up is to ensure optimal health of a pregnant woman throughout her pregnancy. Early detection and appropriate management of health problems help preserve the well-being of both the mother and the foetus. Antenatal check-up generally includes blood testing for blood group, haemoglobin level, mean red cell volume, Rhesus factor, rubella antibody, hepatitis B antigen, syphilis and HIV antibody. One has to understand AIDS, its implications and the meaning of possible results before undergoing the HIV test. AIDS - Acquired Immune Deficiency Syndrome AIDS is caused by the Human Immunodeficiency Virus, in short, HIV. After entering the human body, the virus replicates and destroys the lymph cells. It gradually lowers the body's resistance, leading to opportunistic infections or even lymphoma and ultimately death. The routes of transmission include sexual intercourse, blood contact or from an infected mother to her baby during pregnancy, delivery or breastfeeding. The transmission rate from an infected mother to her baby is 15 to 40%. Ordinary social contact, mosquito or insect bites cannot transmit HIV.
Universal Antenatal HIV Testing HIV test is included in the routine blood testing during antenatal check-up and no separate procedure is required. The HIV antibody test result could be negative (-ve) or positive (+ve). The following is the interpretation of the results : HIV antibody negative (-ve) result A negative result indicates that the tested person is not infected by HIV. However one has to be aware of the problem of 'window period', the time between a person gets infected and the detection of HIV antibodies in the blood. When a person gets infected, the production of antibodies might not be high enough to be detected until three months later. In other words, the HIV antibody testing performed during the window period may give rise to a 'false' negative result in which there is still a chance of transmitting the virus to the foetus. A pregnant mother who has a negative HIV blood result should continue with preventive measures to protect herself and the foetus against transmission of HIV. This includes practising safer sex such as condom use and refraining from needle-sharing in drug users. HIV antibody positive (+ve) result A positive result means that the pregnant woman has got infected with HIV. There is a risk of transmitting the virus to the foetus and to her sexual partner through sexual intercourse. HIV antibody test result is strictly confidential.
Early Detection - How does it benefit the baby? For a pregnant woman, early detection of HIV infection can help reduce the risk of transmitting the virus to her baby. The usual practice is to administer oral antiretroviral therapy (ART) starting in the second trimester of pregnancy and intravenous ART during labour. In those indicated for Caesarean section, the risk of mother-to-child transmission may further decrease. Breast-feeding is strongly discouraged after birth. The baby has to continue oral ART and to be followed up by the paediatrician for several weeks after birth for the prevention and early detection of complications. Once confirmed to be infected, the baby will be given appropriate treatment, and follow-up care to improve his/her health. Early detection and prompt intervention can reduce the risk of HIV transmission from the mother to the child by two-thirds.
Early Detection - How does it benefit the pregnant woman? The sooner the infection is detected, the better outcome it will be. Apart from quality antenatal care, health care providers work together to develop the best management plan to achieve holistic care in the infected person. The pregnant woman may be offered ART to control the HIV disease. Through counselling, the pregnant woman will understand her physical and psychological capacity to cope with the disease, and reach consensus about continuation with pregnancy. The pregnant woman may choose to disclose her HIV status to her sexual partner or family. The health care worker will offer her and her family support and counselling. The infected mother will continue treatment and follow-up of the disease after delivery to prevent further complications and damage to her immune system. She will learn how to take care of her baby. For the protection of yourself and the baby, have the antenatal HIV testing. The sooner you know, the better it will be for you and your baby.
Should you have further queries about universal antenatal HIV testing and AIDS, please talk to your doctor or nurse. You are also welcome to contact our counsellor via the AIDS Hotline at 2780 2211. For further information: AIDS Hotline: 2780 2211 Website : http://www.info.gov.hk/aids Other enquiries: Red Ribbon Centre - UNAIDS Collaborating Centre for Technical Support Address: 2/F., Wang Tau Horn Jockey Club Clinic, 200 Junction Road East, Kowloon, Hong Kong. Tel: (852) 2304 6268 Fax: (852) 2338 0534 Email: rrc@health.gcn.gov.hk

 
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Last revision date: 01 September 2006