Women's attitudes to HIV screening in pregnancy in an area of low prevalence

Objectives: To identify factors that influence acceptance of the human immunodeficiency virus (HIV) screening test by pregnant women. Design: Prospective survey using questionnaires. Setting: An antenatal clinic at a tertiary referral hospital. Population: 200 pregnant women of multiethic origin residing in a low prevalence area. Methods: Two hundred consecutive women attending the antenatal booking clinic were interviewed. We collected data on reasons for opting in or out and factors that could influence the rate of acceptance, such as ethnicity, age, parity, level of education, first language and marital or relationship status. Main outcome measure: Attitudes of pregnant women to HIV screening. Results: The rate of acceptance of HIV screening was 160/200(80%). The most frequent reasons for opting in were the perceived benefits of screening (92/160, 58%) and the fact that the test is now routinely offered (87/160, 54%). The most frequent reason for refusal of screening was perceived low risk of HIV (27/40, 68%). Logistic regression analysis showed that ethnicity, age, parity and level of formal education did not play a role in influencing uptake of the test. However, women whose first language was English were more likely to opt in compared with those whose first language was not English (P = 0.016) and those who were married or in a stable relationship were more likely to opt in than those who were not (P <0.001). Conclusion: We have not reached the national target of 90% in our region. This appears to be due to a combination of factors, the main one being a perception of low risk. Greater knowledge of the ease of transmission of HIV may alter this perception, which may improve acceptance of the test.