HIV mothers denied tests

Babies are being born infected with HIV because their mothers are unaware that they are carrying the virus and are not being offered HIV tests in pregnancy, a new report reveals.

It says hospitals are flouting Department of Health guidelines which state that all pregnant women in areas of high HIV prevalence should be offered a test. The result is that hundreds of women who could take vital drug treatment and avoid breastfeeding to cut the risk of infecting their baby are not doing so.

"It is a tragedy," said Dr Danielle Mercey, senior lecturer in sexually transmitted diseases at University College London Medical School. "Talking to mothers of babies with HIV, many of them ask me why they were not tested during pregnancy. They say: 'Surely I was tested. They did so many blood tests, I thought they must have tested me for that as well'."

In fact, only 13 out of 33 maternity units in London offer tests to all pregnant women. The majority offer tests only to women who are thought to be at high risk (selective policy), or to those who ask for one (request policy). In most maternity units, only 1 per cent of pregnant women are tested.

The report, by the Institute of Child Health, shows that only 22 out of 322 HIV-infected women who went through London's maternity units in 1993-1994, dis- covered they were HIV-positive before delivery. The other 300 remained unaware of their HIV status and could still be unaware, because they are only known to have been positive through anonymous testing of blood samples in ante-natal clinics.

"It is unacceptable that there are so many children being born in this country with HIV infection where it might have been prevented," said Dr Diana Gibb, senior lecturer in paediatric epidemiology at the Institute of Child Health, one of the authors of the report.

"Of over 400 children in this country who have been infected with HIV from mother-to-child transmission, nearly two-thirds are from London. At least 50 babies have developed the Aids-defining illness, pneumocystis carinii pneumonia, many of whom have died, and the great majority of the mothers did not know that they had the virus."

Research midwife Sandra MacDonagh, of the Institute of Child Health, who carried out the study, published in the BMJ and British Journal of Midwifery, says the transmission rate of the virus from mother to baby in the UK is 15-20 per cent, but rises to about 30 per cent if she breastfeeds.