Mercey D, Helps B A, Copas A, Petruckevitch A, Johnson A M, Spencer J
Academic Department of Genitourinary Medicine, University College London Medical School, UK.
Br J Obstet Gynaecol. 1996 Nov;103(11):1129-33. doi: 10.1111/j.1471-0528.1996.tb09596.x.
To assess the uptake of universal voluntary named HIV testing of hospital booked antenatal women and to identify behavioural and demographic factors associated with testing. To identify the number of previously undiagnosed women detected by the new policy and to compare prevalence among those testing with that measured by unlinked anonymous monitoring.
Self-completion questionnaire and data abstraction from structured booking forms and virology laboratory records.
Central London teaching hospital antenatal clinic.
One thousand three hundred and seventy-four women booking with a hospital based midwife during the 49 weeks from 27 July 1993 to 1 July 1994.
Before the introduction of the new testing policy fewer than 10 women per year had an HIV test, and during the study this rose to 41% (548/1340). In univariate analysis, caucasian and Mediterranean ethnic origin, fewer previous live births, and more than one lifetime sexual partner were associated with higher uptake of HIV testing. In a multivariate model only the number of previous live births and ethnic origin remained significantly associated with testing. Six women out of 828 (1%) who completed the question about nonprescribed drug use stated that they had injected drugs, and four of these women accepted a test. Two women, both with recognised major risk factors for HIV infection, were diagnosed HIV antibody positive (a prevalence in the tested women of 0.36%). A further three women were already known to be HIV antibody positive. During the 12 months from July 1993 seven women (0.24%) were found to be positive by unlinked anonymous testing.
The introduction of a universal approach to antenatal HIV testing appears feasible: it increased the uptake of the test and detected previously unrecognised infections. Many women chose not to be tested, however, and cases remained undiagnosed. Further studies are required to examine different models of offering HIV testing, reasons for declining the test, and the cost-benefit of antenatal HIV screening.
评估医院预约产前检查的妇女接受普遍自愿实名艾滋病毒检测的情况，并确定与检测相关的行为和人口统计学因素。确定新政策检测出的既往未诊断妇女的数量，并比较检测人群中的患病率与非关联匿名监测所测患病率。
自填问卷以及从结构化预约表格和病毒学实验室记录中提取数据。
伦敦市中心教学医院产前诊所。
1993年7月27日至1994年7月1日的49周内，在医院助产士处预约的1374名妇女。
在新检测政策实施前，每年进行艾滋病毒检测的妇女少于10名，而在研究期间，这一比例升至41%（548/1340）。单因素分析显示，白种人和地中海族裔、既往活产次数较少以及终身性伴侣超过一人与艾滋病毒检测接受率较高有关。在多变量模型中，只有既往活产次数和族裔与检测仍有显著关联。在828名完成非处方药物使用问题的妇女中，有6名（1%）表示曾注射过毒品，其中4名接受了检测。两名妇女，均有公认的艾滋病毒感染主要风险因素，被诊断为艾滋病毒抗体阳性（检测妇女中的患病率为0.36%）。另有三名妇女已知为艾滋病毒抗体阳性。在1993年7月后的12个月里，通过非关联匿名检测发现7名妇女（0.24%）呈阳性。
采用普遍的产前艾滋病毒检测方法似乎是可行的：它提高了检测接受率，并检测出了既往未被识别的感染病例。然而，许多妇女选择不进行检测，病例仍未得到诊断。需要进一步研究，以探讨提供艾滋病毒检测的不同模式、拒绝检测的原因以及产前艾滋病毒筛查的成本效益。
