HIV Testing of Pregnant Women (November 1998)
Adopted by the Canadian AIDS Society Board of Directors, November 1998.
At its November 1998 meeting, the Canadian AIDS Society Board of Directors considered the issues involved in the HIV testing of pregnant women. While the Board of Directors recognized that the early detection of HIV status in pregnant women may offer them access to antiretroviral therapies which reduce the chance of perinatal transmission, the Board felt that the issue of testing is serious enough to warrant other considerations.
In keeping with the Canadian AIDS Society’s established position that HIV testing only take place with the specific informed consent of the individual being tested, the Board believes that HIV testing should be offered to all pregnant women with appropriate pretest counselling and information. Pregnant women should then have the option to choose to test or not, and should be free of reprisal independent of their decision. Offering the HIV test only to women perceived to be at risk for HIV places too much emphasis on the treatment provider and may reinforce stereotypes about risk behaviour. Routinely including the test as part of prenatal screening examinations (or allowing women to "opt-out" of the test) may blur the specific counselling and consent necessary for HIV testing and therefore should be avoided.
The Board of Directors of the Canadian AIDS Society also believes that HIV-positive pregnant women should be made aware of all available information on pregnancy and HIV including the use of AZT and other antiretrovirals as well as non-pharmaceutical methods of decreasing the risk of perinatal transmission. In addition, the Board recognizes the right of HIV-positive women to make decisions about their bodies and their health and stresses that pregnancy should not be a reason to withhold HIV therapies from women.
Finally, in addressing the issue of HIV testing and pregnancy, the CAS Board emphasizes that the issue of perinatal transmission highlights the increased rate of HIV among Canadian women and calls for increased resources to be allocated to HIV prevention campaigns targeted to women.