This paper from the World Health Organization aims to assess the impact of routine antenatal HIV testing for preventing mother-to-child transmission of HIV (PMTCT) in urban Zimbabwe.
The study used community counselors, trained in routine HIV testing policy using a specific training module from June 2005 through to November 2005. Key outcomes during the first six months of routine testing were compared with the prior six-month “opt-in” period, and clients were interviewed.

The report found:
• of the 4,551 women presenting for antenatal care during the first six months of routine HIV testing, 99.9 per cent were tested for HIV compared with 65 per cent of 4,700 women during the last 6 months of the opt-in testing with a corresponding increase in the numbers of HIV-infected women identified antenatally
• during routine testing, more HIV-infected women collected results compared to the opt-in testing (908 compared with 487) resulting in a significant increase in deliveries by HIV-infected women
• more mother/infant pairs received antiretroviral prophylaxis compared to the opt-in testing
• more mother/infant pairs followed up at clinics.
• women were satisfied with counselling services and most (89 per cent) stated that offering routine testing is helpful. HIV-infected women reported low levels of spousal abuse and other adverse social consequences.
The authors concluded that routine antenatal HIV testing should be implemented at all sites in Zimbabwe to maximize the public health impact of PMTCT.