HIV in Pregnant Women in the Philippines: Revisiting Prospects for Universal Screening
The Philippines is one of nine countries globally with rapidly increasing rates of HIV infection. Annual reported cases have increased 34-fold in the last decade. A local prevalence study of 3,000 pregnant women in 1998 failed to find a single case of HIV. This study aims to determine whether universal HIV screening in pregnant women should be initiated in the light of the large number of newly-diagnosed cases.
Following institutional review board approval, adult pregnant patients at the Philippine General Hospital (PGH) were recruited into the study. PGH is the largest tertiary-care government hospital in the country and is a national referral center. 400 pregnant women were offered free HIV testing and 387 women qualified for the study. Demographics and risk factors for HIV were recorded and analyzed. Screening was done using ELISA/ECLIA testing (Abbott Architect HIV Ag/Ab) with Western blot for confirmation.
Demographics and HIV risk factors are shown in Table 1. No pregnant women were found to have HIV. Two false positives occurred.
In order to better analyze risk factors for screening, we compared the demographics and risk factors of the study patients with the records of all (N=4) pregnant HIV patients seen in our HIV clinic at PGH. Differences between HIV-positive versus HIV-negative pregnant women included more sexual partners (5 vs. 2); higher rates of illicit drug use (50% vs. 0.78%), sex with foreigners (50% vs. 1.6%) STD rates (25% vs. 3.9%), sex with illicit drug users (25% vs. 3.1%), and receiving money for sex (50% vs. 0.52%).
Universal screening for HIV in pregnant Filipino women is not supported by the findings of this study despite the tremendous increase in HIV prevalence in the Philippines. A larger sample size may be useful to strengthen this assertion. Targeted HIV screening of pregnant women, particularly female sex workers, drug users and those with multiple partners should be offered.
|Age (years)||Mean: 28.4 SD: 6.2||Range 19-46|
|Age of gestation (weeks)||Mean: 27.06 SD: 8.01||Range: 4 to 38|
|Number of partners (lifetime)||Mean: 1.92 SD: 1.61||Range: 1 to 20|
|History of sexually transmitted disease||Yes: 15 (3.88%)||No: 372 (96.12%)|
|Condom use||Yes: 65 (16.80%)||No: 322 (83.20%)|
M. J. M. Bartolome,
M. Alejandria, None
J. Lim, None
A. Bandola, None
R. Duque, None
E. M. Salvana, None