- 1.All pregnant women should be offered HIV screening with appropriate counselling. This testing must be voluntary. Screening should be considered a standard of care, although women must be informed of the policy, its risks and benefits, and the right of refusal. Women must not be tested without their knowledge (II-2 B).
- 2.Pre-test counselling and the patient's decision about testing should be documented in the patient's chart (III-B).
- 3.Women who decline screening should still have concerns discussed and should continue to receive optimum antenatal care (III-C).
- 4.Women should be offered HIV screening at their first prenatal visit (I-A).
- 5.Women who test negative for HIV and continue to engage in high-risk behaviour should be retested in each trimester (II-3 B).
- 6.Women with no prenatal care and unknown HIV status should be offered testing when admitted to hospital for labour and delivery. Women at high risk for HIV and with unknown status should be offered HIV prophylaxis in labour, and HIV prophylaxis should be given to the infant post partum (III-B).
- 7.Women who test positive for HIV should be followed by practitioners who are knowledgeable in the care of HIV-positive women (III-C).
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This guideline has been reviewed by the Maternal Fetal Medicine Committee and approved by the Executive and Council of the Society of Obstetricians and Gynaecologists of Canada.