New Zealand moves to routinely offering antenatal HIV screening

New Zealand will progressively move to a policy of routinely offering antenatal HIV screening as part of antenatal care, Ministry of Health spokesman Dr Pat Tuohy said this week.

This approach will begin in the Waikato District Health Board (DHB) region, as well as one of the Auckland DHBs. Experience in these areas will help shape the wider national roll-out over a period of three years.

At the moment pregnant women are routinely offered blood tests for:

• blood grouping for Rhesus disease

• anaemia

• hepatitis

• rubella immunity

• gestational diabetes, and

• syphilis.

The current antenatal HIV screening policy is based on identification of high-risk women (through a series of screening questions) early in pregnancy, and referral of women identified as high risk -- or where there is uncertainty -- for HIV testing. This policy has been in place since 1997.

Dr Tuohy said there was a growing consensus in New Zealand supporting a policy change, and routine antenatal HIV screening was now part of antenatal care in many other developed countries, including Australia and the United Kingdom.

``HIV screening in pregnancy is a contentious issue that has generated considerable debate. Although the estimated prevalence of antenatal HIV in this country is low, there are significant implications for the women involved, as well as their families and communities,'' Dr Tuohy said.

``With this policy change, we can reduce the number of babies affected by this disease.''

Information for women, education of professionals caring for pregnant women, and appropriate quality and monitoring mechanisms will be in place in the Waikato and Auckland areas from the outset.

Antenatal care providers will all be informed of the proposed change and reminded of the importance of identifying high-risk women as per the current policy until routine screening is rolled out in their area.

The National Health Committee reviewed the issue of antenatal HIV screening and reported to Health Minister Annette King in October 2004. The NHC noted that the current ‘high risk’ approach was not well implemented, and recommended piloting a routine offer of antenatal screening in an area of Auckland, as well as improving the education of professionals elsewhere on the existing ‘high risk’ policy. The NHC advice was referred to the Ministry for response.

The Ministry had carefully considered the NHC advice and engaged in further discussions with professionals and consumer groups.

Dr Tuohy said that the Health and Disability Commissioner highlighted issues with the current policy in his report HIV screening in pregnancy. This was consistent with the advice from the NHC, and the Ministry is committed to implementing the necessary changes