Letter: Voluntary HIV tests

Sir: We support the plan to offer HIV tests to pregnant women, but its success will depend on the test being offered, not imposed, with no discrimination against those who refuse (report, 13 August).

We have had a stream of complaints from women (including a health visitor and a midwife) who tried to refuse other antenatal tests and were bullied or treated like pariahs. This has had the effect of some opting out of care - for example, some Orthodox Jewish women choose not to have antenatal care until 24 weeks in order to avoid pressure.

Any attempts to force women to have caesarean sections or abstain from breastfeeding will be counter-productive.

A particular problem for HIV-positive mothers is confidentiality for them and their children. With team care and computerisation there is no possibility of the patient choosing who knows what.

Other antenatal screening tests have caused huge problems, with false positives and false negatives, and promised "counselling" being non-existent or of poor quality. Screening has often greatly added to anxiety in pregnancy and this stress can in itself damage foetal growth. We hope that the Department of Health has learnt from past mistakes.

BEVERLEY A LAWRENCE BEECH

Honorary Chair

JEAN ROBINSON

Honorary Research Officer

AIMS

Iver, Buckinghamshire