Ontario’s Prenatal HIV Testing Program
The Ontario Prenatal HIV Testing Program offers universal HIV testing to all pregnant women and women considering pregnancy. Since the program began in 1998, nearly 200 infant HIV infections have been prevented and the program has helped to ensure that the HIV-positive women who are identified never develop AIDS. Over 98% of Ontario women receiving prenatal blood testing are now being tested for HIV.
Why does it matter?
When an HIV-positive woman gives birth without prior HIV treatment, the risk of perinatal transmission to her infant ranges from 25-40%. Women prescribed modern HIV antiretroviral drugs four weeks or more before delivery have a perinatal transmission rate of 0.1%. Prompt maternal treatment prevents infant infection, while ongoing treatment protects the mother’s health. Current therapies can reduce the amount of HIV in a person’s body to undetectable levels preventing any future sexual transmission.
How does testing happen?
HIV testing is included on the standard Prenatal Screening Requisition available from Public Health Ontario, and may be completed at any point during pregnancy. The lab will use the same blood sample (red top tube) as other prenatal tests for rubella, syphilis and hepatitis B. Women testing for HIV must be explicitly asked to consent to HIV testing and understand that:
- If they are HIV-positive, transmission of HIV to their infant can be prevented
- HIV does not inevitably lead to AIDS. It is a chronic disease, and they will need to take medication for the rest of their lives to remain healthy.
- A positive HIV test is reportable. Public Health staff will follow-up with your patient to offer care and support, as well as the testing of their partner(s).
Reassure your patients that if they test positive for HIV, you will help them begin care. Learn more about providing optimal HIV care and the resources available to you.
If your patient wants to test for HIV without using their name, you or your patient can call the Sexual Health Infoline Ontario (SHILO) toll-free at 1-800-668-2437, to find the anonymous HIV testing clinic nearest the patient.
If you do not request HIV testing as part of prenatal screening, you will receive a reminder letter.
 Bitnum A et al. Prevention of vertical HIV transmission and management of the HIV-exposed infant in Canada in 2014. Can J Infect Dis Med Microbiol 2014 March/April; 25(2). At: https://www.cps.ca/uploads/committees/16160_bitn.pdf