Why are HIV-positive mothers refusing to have their children screened for vertically transmitted HIV infection?

A previous audit showed that the HIV status of the majority (73%) of children of HIV-positive mothers attending a genitourinary clinic in the United Kingdom was unknown because mothers did not take up the offer of testing. The objectives of a re-audit were to establish the impact of the audit process on the uptake of testing and reasons for not taking up the offer of screening of offspring. One year after the previous audit, 13/92 (14%) of children not previously tested had their HIV status established. The reason for not testing was, in 43/52 (82%) mothers, the perception that a well child can not be infected with HIV. This was the only reason for not having their children tested in 16 mothers (31%). The next most common theme was fear of disclosure to others, in 29 (56%). The barriers for screening included fear of feeling guilty if the child was found to be positive.