       Document 0208
 DOCN  M95B0208
 TI    Is HIV testing in antenatal clinics worthwhile? Can we afford it?
 DT    9511
 AU    Chrystie IL; Zander L; Tilzey A; Wolfe CD; Kenney A; Banatvala JE;
       Department of Virology, United Medical School of Guy's and St; Thomas's,
       London, UK.
 SO    AIDS Care. 1995;7(2):135-42; discussion 143-5. Unique Identifier :
       AIDSLINE MED/95345143
 AB    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 pounds to
       193,900 pounds), 80% of which relates to the need to obtain informed
       consent, was approximately 2.7-3.5 times that calculated by 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
       resources 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 unsuccessful.
 DE    AIDS Serodiagnosis/*ECONOMICS  Cost Control  Cost-Benefit Analysis
       Counseling/ECONOMICS  Europe  Female  Financing, Government  *Health
       Care Costs  Health Priorities  Human  Informed Consent  Outpatient
       Clinics, Hospital  Patient Acceptance of Health Care  Pregnancy
       Prenatal Care/*ECONOMICS  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

