Routinely Offered Prenatal HIV Testing

To the Editor: Perinatal infections have been recognized as the chief cause of HIV disease in children for several years. The Centers for Disease Control in 1985¹ and the American College of Obstetricians and Gynecologists in 1987² have advocated prenatal HIV testing for women with self-identified risk factors for HIV infection. Subsequent studies have documented the failure of clinicians to elicit from patients the risk factors that can identify many pregnant women infected with HIV.^{3, 4} This failure stems in part from women's desire not to disclose risky behavior. Programs that offer HIV testing only to women with acknowledged risk factors.