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Barriers to universal prenatal HIV testing in 4 US locations in 1997
Journal Title
American Journal of Public Health
Readers/Advisors
Journal Title
Term and Year
Publication Date
2001-05-01
Book Title
Publication Volume
91
Publication Issue
5
Publication Begin
727
Publication End
733
Number of pages
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Research Projects
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Journal Issue
Abstract
Objectives: We determined rates of prenatal HIV testing and investigated barriers to testing.
Methods: We surveyed 1362 representative parturient women from 7 hospitals in 4 locations of the United States.
Results: Overall, 89.9% of women reported being offered HIV testing and 69.6% reported being tested. Proportions of women not offered testing differed by location (range = 5.2%-16.3%), as did proportions not tested (range = 12.2%-54.4%). Among women who perceived that their clinicians had not recommended testing, 41.7% were tested, compared with 92.8% of women who perceived a strong recommendation (P < .05). Private insurance for prenatal care was also associated with not being tested. Women gave multiple reasons for not being tested, most commonly not being at risk, having been tested recently, and the test's not being offered or recommended, cited by 55.3%, 39.1% and 11.1% of women, respectively.
Conclusions: Although most parturient women were offered a prenatal HIV test and got tested, testing proportions did not reach national goals and differed significantly by location and payment status. Concern about testing consequences was not a major barrier. Perception of clinicians' recommendations strongly influenced testing. Changing provider practices will be essential to implementing universal prenatal HIV testing.
Citation
Royce RA, Walter EB, Fernandez MI, Wilson TE, Ickovics JR, Simonds RJ; Perinatal Guidelines Evaluation Project. Barriers to universal prenatal HIV testing in 4 US locations in 1997. Am J Public Health. 2001 May;91(5):727-33. doi: 10.2105/ajph.91.5.727. PMID: 11344880; PMCID: PMC1446691.