WHO Antenatal Care Guideline Implementation Guide, published by World Health Organization (WHO). This guide is not an authorized publication; it is the continuous build for version 0.3.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/costateixeira/smart-anc/ and changes regularly. See the Directory of published versions
ANC.DT.29 HIV risk counselling: When:Named Event: ANC.B9. Conduct laboratory tests and imaging Then:
If the woman lives in a setting with a generalized HIV epidemic, or her partner is HIV positive, or she injects drugs, or she is a sex worker, then she is at high risk for HIV – counselling should be given to provide prevention options
Provide comprehensive HIV prevention options:
– STI screening and treatment (syndromic and syphilis)
– Condom promotion
– Risk reduction counselling
– Pre-exposure prophylaxis (PrEP) with emphasis on adherence
– Emphasize importance of follow-up ANC contact visits If:Applicability: (((((("HIV status" = "HIV negative")
AND ("Prevalence of HIV in pregnant women in the catchment area" > 1%))
OR (("HIV status" = "HIV negative")
AND ("Partner HIV status (reported)" = "HIV positive")))
OR (("HIV status" = "HIV negative")
AND ("Partner HIV test result" = HIV positive")))
OR (("HIV status" = "HIV negative")
AND (Partner HIV status (confirmed)" = "HIV positive")))
OR (("HIV status" = "HIV negative")
AND (Current alcohol and/or other substance use" = "Injectable drugs")))
OR (("HIV status" = "HIV negative")
AND ("Occupation" = "Employment that puts woman at increased risk for HIV (e.g. sex worker)")) (Should Conduct counselling on HIV risk)
Oral pre-exposure prophylaxis (PrEP) containing tenofovir disoproxil fumarate (TDF) should be offered as an additional prevention choice for pregnant women at substantial risk of HIV infection as part of combination prevention approaches.
See "PrEP offering framework" – a suggested prioritization framework for offering PrEP to pregnant and breastfeeding women (below). If:Applicability: "Population incidence of HIV in the absence of PrEP" > 3 per 100 person-years (Should Conduct counselling on pre-exposure prophylaxis (PrEP) for HIV prevention)
Encourage woman to find out the status of her partner(s) or to bring them during the next contact visit to get tested If:Applicability: ("Partner HIV status (reported)" = "Inconclusive")
OR ("Partner HIV test conducted" = FALSE) (Should Conduct counselling on HIV risk 2) Then: