Although all pregnant women in Canada are supposed to be offered voluntary HIV testing to allow treatment and possible prevention of transmission to the baby, cases are still missed. Ari Bitnun and colleagues retrospectively reviewed the hospital charts of all infants diagnosed with perinatally acquired HIV infection between August 1999 and July 2001 and found 6 cases involving HIV-positive infants whose mothers did not know their own HIV status before or during their pregnancy.
The authors suggest that the incomplete application of guidelines for universal HIV prenatal counselling and voluntary testing are the reasons for continued perinatal transmission. They recommend universal HIV testing and counselling for pregnant women unless the woman specifically objects.
In a related commentary, Kathleen Steel O’Connor and Susan MacDonald discuss 5 critical steps needed to prevent perinatal HIV transmission.
Failure to prevent perinatal HIV infection
— A. Bitnun et al
Aiming for zero: preventing mother -to-child transmission of HIV
— K.S. O’Connor, S.E. MacDonald
Canadian Medical Association Journal