[HIV screening for pregnant women in Israel: evaluation of current selective screening recommendations in the light of the local epidemiology

HIV-testing in Israel for pregnant women (PW) is selective since the year 1998 and recommended if they or their sex partners (SP] are at high-risk for HIV-infection. HIV-infected PW, citizens and non-citizens alike, are eligible for free HIV-care and treatment. This study describes the current recommendations and HIV epidemiology in Israel. A retrospective study was conducted describing risk groups of HIV-infected PW between the years 1985 and 2010. The source of the data was the National HIV registry. During 25 years of follow-up, 204 vertically HIV-infected children were reported to the Ministry of Health (MoH). Of those, 87 (42.4%) were born in Israel to 83 PW, and the others were born overseas. Of these 87 children, 35 (40.2%) were born to 33 PWwho were unaware of their HIV-infection prior to Labor (31 citizens and 2 non-citizens). Of those, 22 (66.7%) were born in high-prevalence countries, eight (24.3%) were infected from their heterosexual SP, one (3%) used drugs intravenously, one (3%) had a SPwho used drugs intravenously, and one (3%) had a SP who received HIV-infected blood. During the period 2002-2011, the treatment costs of 54 non-citizens PW was covered by the MoH and no vertical infection was diagnosed. Most vertical transmissions occurred overseas, or by PW who were aware of their infection prior to Labor. Most of the PW who were unaware of their HIV-infection and gave birth in Israel belonged to the known risk groups for whom testing is recommended. SeLective HIV-testing in these PW should be encouraged, along with a vigilant surveiLLance of new HIV-infections in women.