Is HIV testing in antenatal clinics worthwhile ? Can we afford it ? HIV testing - ten years on.
Since 0.2-0.4% of pregnant women attending antenatal clinics (ANC) at St Thomas's Hospital are HIV positive, and as the Department of Health (DH) have recommended that universal voluntary HIV testing be made available to women attending ANC in areas of « known or suspected higher prevalence of HIV infection », we examined the implications of the DH initiative in an Inner London Teaching Hospital as well as in a General Practice involved in shared care.
The cost of the programme (£148,300 to £193,900), 80% of which relates to the need to obtain informed consent, was approximately 2.7-3.5 times that calculated bu the DH.
The DH based much of their costing on additional time for counselling rather than calculating the additional staff required.
We estimated that 25% of women will require specialized counselling since 17% are of African ethnicity and others are injecting drug users or « worried well ».
Various means of reducing costs were considered but, until such time as explicit, informed consent is no longer considered necessary, the above ressources will be required.
Unless the DH continues to provide central direction to Providing Agencies to give priority to these recommendations and, where necessary, provides additional funding, we fear that this important public health initiative will be unsucessfull.
Mots-clés Pascal : Programme sanitaire, Dépistage, Prénatal, Virus immunodéficience humaine, Service hospitalier, Analyse coût, Economie santé, Royaume Uni, Etude critique, Politique sanitaire, Homme, Conseil, SIDA, Lentivirinae, Retroviridae, Virus, Europe, Virose, Infection, Immunopathologie, Immunodéficit
Mots-clés Pascal anglais : Sanitary program, Medical screening, Prenatal, Human immunodeficiency virus, Hospital ward, Cost analysis, Health economy, United Kingdom, Critical study, Health policy, Human, AIDS, Lentivirinae, Retroviridae, Virus, Europe, Viral disease, Infection, Immunopathology, Immune deficiency
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 95-0283933
Code Inist : 002B30A03B. Création : 01/03/1996.