HIV testing in a national sample of pregnant US women: who is not getting tested?
ABSTRACT It is recommended that all pregnant women in the US receive an HIV test as early as possible during prenatal care to allow HIV-infected women to begin receiving anti-retroviral drugs when they most effectively prevent transmission. We analyzed interview data from a nationally-representative sample of pregnant women to examine the extent of HIV testing among pregnant women and the characteristics associated with testing, including access to healthcare. We used data from the combined 2001 and 2002 Behavioral Risk Factor Surveillance System, a nationally-representative telephone-based behavioral survey of adults, aggregated across all states to yield national estimates. Among 4,855 women pregnant at interview we looked at the percentages recently tested and never tested by major populations subgroups and assessed differences using chi-square tests and multiple logistic regression analysis. Pregnant women were tested at a much higher rate than other women of the same age - 54.1% had been tested in the past year compared with 15.4% of non-pregnant women. Categories of pregnant women that were more likely to never have been tested for HIV include those without a health plan or insurance (adjusted odds ratio (AOR): 1.6) and those without a personal doctor (AOR: 1.7). Women with knowledge of methods to prevent perinatal HIV transmission were less likely to have never been tested (AOR: 0.8). Attaining the recommended goal of universal prenatal testing will require attention to women without personal doctors or health insurance.
SourceAvailable from: Carlos A Sariol
Article: Names in bold are those of staff or full-time on-site contractors in DHAP whose published affiliation includes (at a minimum) CDC (preferably, the published affiliation of a staff member or a contractor specifies the Divisions of HIV/AIDS Prevention). That is, if a contractor's published affiliation is only the name of the contracting company, that contractor's name is not bolded on this list
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ABSTRACT: Abstract Routine testing is the cornerstone to identifying HIV, but not all substance abuse treatment patients have been tested. This study is a real-world evaluation of predictors of having never been HIV tested among patients initiating substance abuse treatment. Participants (N = 614) from six New England clinics were asked whether they had ever been HIV tested. Eighty-five patients (13.8%) reported having never been tested and were compared to those who had undergone testing. Clinic, male gender (adjusted odds ratio (AOR) = 1.91, 95% confidence interval (CI) = 1.07-3.41), and having fewer employment (AOR = 0.31; 95% CI = 0.11-0.88) and medical problems (AOR = 0.40, 95% CI = 0.17-0.99) were independently correlated with having never been HIV tested. Thus, there is still considerable room for improved testing strategies as a clinically significant minority of substance abuse patients have never undergone HIV testing when they initiate treatment.Journal of psychoactive drugs 07/2014; 46(3):208-214. DOI:10.1080/02791072.2014.915363 · 1.10 Impact Factor
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ABSTRACT: HIV testing is recommended as part of routine preconception and prenatal care but some cases of vertical transmission still occur because of missed HIV testing in pregnancy. We estimated the percentage of women missing HIV testing before delivery, and we evaluated factors related with it. An anonymous survey was distributed to women giving birth during a two-week period in the maternity units of hospitals in the Lazio region of Italy in 2011. Among the 1568 women who filled out the questionnaire, only 33.6% had an HIV test prior to conception, while 88.2% were tested during pregnancy; main reasons reported for missed testing were: not requested by the gynaecologist (57.0%), performed previously (20.7%), requested by the gynaecologist but not done (13.3%) and structural/organisational barriers (4.4%). The percentage of women who missed the HIV test as part of preconception care or during pregnancy was 9.1% (95% confidence interval, CI: 7.7-10.6). Multivariate analysis showed that those with missed test were younger (p = 0.05), of lower education level (p < 0.01), with a lower HIV-knowledge score (p < 0.01) and with fewer visits during pregnancy (p < 0.01). Around 10% of delivering women were not tested for HIV during pregnancy or as part of preconception care. Absence of a specific request by the gynaecologist was the most frequent reason given. The association of missed HIV testing with poor sociocultural level and limited maternal HIV knowledge emphasise the importance of promoting HIV information among women and prenatal care providers. Strategies to increase routine testing may include the adoption of an opt-out approach. Finally, availability of rapid HIV testing in the delivery room should be encouraged.AIDS Care 11/2013; DOI:10.1080/09540121.2013.861572 · 1.60 Impact Factor