We have read with interest the paper entitled "Is HIV testing in antenatal clinics worthwhile? Can we afford it?" which JM was recently asked to review. We feel that it is extremely important, as the paper suggests, to look at the cost implications of the DOH recommendation to offer universal voluntary HIV testing in antenatal clinics in "known or suspected areas of higher seroprevalence". It is also important, within this, to consider the rationale behind voluntary HIV testing and it is this that has prompted the following communication. Various points made by the authors seem worthy of comment in the hope that it will generate further debate around this important issue: