When Amanda Mandawoub's obstetrician recommended she be screened for HIV, she was shocked and a little offended. But it didn't take her long to agree to test while pregnant with her daughter Maegan, now almost two. "Anything that's going to protect me and my daughter, I'll do," the first-time mother said on Dec. 3 at the launch of a poster to promote HIV screening in the Waterloo Region for all pregnant women and women planning a pregnancy. The poster is part of an awareness campaign by the Region of Waterloo Public Health.

Maegan and four other babies featured on the poster are all healthy and HIV-free, as are their mothers. But in 2001, two HIV-infected babies were born in Waterloo Region to mothers who had not received screening. Drug therapy during pregnancy dramatically lowers a mother's chance of transmitting the virus to her baby.

Regional screening rates in 2001 were only 45 percent, compared to 54 percent provincially. But public health staff members have been educating doctors and midwives and, in 2002, the rate rose to 71 percent -- just shy of the provincial average of 73 percent.

Since 1998 in Ontario, all pregnant women are to be offered an HIV test, performed only after counseling and informed consent. Previously, screening was only offered to those with identified risk factors.

Some physicians feel the time and education required for pre-natal counseling, informed consent and testing "is a little onerous in a busy office practice," said Dr. Stephen Halmo, chief of reproductive medicine at Grand River Hospital. Also, he said, there is still stigma around HIV screening. The poster of the babies will help reduce the stigma, he said.

Halmo said it would be more effective if Ontario would adopt universal pre-natal screening for HIV, as is done for other STDs such as syphilis and hepatitis. Alberta began universal screening in 1998 and its testing rate jumped to 96 percent. Ontario women can still opt out if they wish.

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