People contemplating pregnancy or seeking antenatal care should be made aware of the benefits of HIV testing. They should be made aware that there is a high risk of antenatal, intrapartum or postpartum transmission, which can be almost entirely eliminated with prevention strategies.
For more information about recommended clinical practice for antenatal care, refer to the 2020 National HIV Testing Policy, which states that antenatal testing should be recommended to all pregnant people, and must only be performed with the informed consent of the person. The Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) guidelines state that in the absence of complications ‘all pregnant people should be recommended to have HIV screening at the first antenatal visit’.
Resources #
Australian Pregnancy Care Guidelines (last accessed February 2024)
ASHM vertical transmission of HIV management guidelines (last accessed February 2024)
RANZCOG Routine antenatal assessment in the absence of pregnancy complications (last accessed February 2024)
Legal Considerations #
Given the knowledge and means available to prevent vertical transmission, a medical practitioner who fails to offer HIV antenatal testing or adequately explain the material risks associated with being tested or not being tested, could be held liable if the person’s HIV-positive status goes undiagnosed.
Informed consent prior to pregnancy HIV testing is vital. People who are pregnant must not feel compelled to agree to an HIV test and must not be coerced into an HIV test. Discussion of key issues prior to testing enables identification of those indicated for testing and prepares the person for the possibility of an HIV-positive result.
Considerable anxiety and shame may be associated with an HIV diagnosis during pregnancy. Special attention should be given to psychosocial issues, care and support, as well as contact tracing.
More information on managing HIV-related antenatal testing issues #
Australian STI management guidelines for use in primary care
ASHM Pregnancy and midwifery considerations in HIV
2020 National HIV Testing Policy (last accessed March 2023)
RANZCOG Routine antenatal assessment in the absence of pregnancy complications
