HIV-antibody testing has been carried out as a routine among pregnant women in Norway since September 1987. Up to September 1991 (later information is incomplete) 339,823 women have been tested. 25 of these were positive. In this survey we interviewed by questionnaire 55 physicians and nurses who had been asked for a second blood sample from their patients. None of the physicians who had tested the 25 HIV-positive women were included. Among these 55, nine stated that the women had suffered psychological distress after the second testing, and one reported that the woman in question had chosen to have an abortion. The study demonstrates possible opportunities for improving the handling of information, both between laboratories and physicians/nurses and between physicians/nurses and the women who are asked to give a second blood sample. We also interviewed 290 physicians who had asked for a HIV-test for pregnant women but had received no false positive results (the number of respondents was 258). Among a total of 379 physicians and nurses, one third stated that they seldom or never asked explicitly if the woman wanted to be tested. 88% were in favour of routine testing and 97% reported a positive or very positive attitude among the pregnant women towards screening. Nearly one third stated that they had insufficient knowledge about the significance of a false positive test result.
In Sweden, voluntary testing for HIV (human immunodeficiency virus)-antibodies has been given an important place in combating AIDS (acquired immunodeficiency syndrome). To elicit the reasons why people seek voluntary testing on their own initiative outside general screening programmes, during a three-year period (1989-91) applicants at a major urban testing locale were asked to fill in an anonymous questionnaire, which was completed by 68.6 per cent (831/1,212) of those eligible. Of the 831 respondees (both men and women), 88.9 per cent cited recent casual sexual contact as the reason why they might be at risk. Although in most cases no particular risk factors were reported to be associated with the sexual contact, in 17 cases (2.3 per cent) the partner was known to be an HIV-carrier. Of 664 people completing the item on the questionnaire 208 (31.3 per cent) reported the sexual contact to have occurred abroad. When the reason for undergoing the test was not possible recent exposure, the commonest reasons given were persistent anxiety or the establishment of a new sexual relationship. Only one of the 1,212 tests performed was HIV-positive.
Our objective was to understand the circumstances surrounding HIV testing among recent HIV seroconverters (n=80) compared to HIV-negative controls (n=106) in Ontario, Canada using self-reported interview data. Diagnosis of symptomatic primary HIV infection (SPHI) was defined as diagnosis by the participant's physician. Testing in response to symptoms was reported by 42% of seroconverters vs 12% of controls. More controls than seroconverters tested in response to risk behaviour (70% vs 50%) or from a desire to know their status (34% vs 12%). Among seroconverters, 76% reported 'flu-like' illness during the time period of infection, 66% had symptoms consistent with SPHI, and 35% reported a physician's diagnosis of SPHI. Compared to seroconverters with undiagnosed SPHI, more of those diagnosed with SPHI had rash (odds ratio=4.5). SPHI plays a significant role in HIV testing and subsequent early diagnosis in this population. More seroconversions could be diagnosed with better patient and physician awareness of its symptoms.