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: Increasing the rates of human immunodeficiency virus (HIV) testing among groups not traditionally perceived as being at high risk has been advanced as a primary strategy in the effort to combat the HIV epidemic. We conducted a pooled cross-sectional analysis of data from 146 868 participants aged 18 to 64 years in the 2000-2005 National Health Interview Surveys to describe longitudinal trends in HIV testing rates in the US population and differences between planned and actual testing across demographic and risk groups. Multivariable logistic models were estimated to assess correlates of perceived risk for HIV infection and planned and actual HIV testing. Difference-in-differences models examine how differences between planned and actual testing varied with demographic characteristics, perceived risk, alcohol consumption, depression, and health behaviors and access. Rates of HIV testing remained relatively unchanged from 2000 to 2005 (mean rates for lifetime and past year, 37% and 10%, respectively) and varied substantially by sex and race, with female and minority (nonwhite) populations more likely to get tested. Rates were higher in individuals reporting greater risks of HIV infection. However, even among respondents reporting medium or high risks of contracting HIV, less than 25% reported an HIV test in the previous year. Those with a higher perceived risk, more alcohol consumption, and more depressive symptoms had higher rates of both planned and actual testing but also demonstrated the greatest deficit of actual relative to planned testing. In the United States, HIV testing rates remain low, nationally and in high-risk populations; low rates are likely contributing to a substantial number of undiagnosed cases of HIV. Despite above-average testing rates, populations considered to be at increased risk for HIV infection still demonstrate the need for improved access to and utilization of testing.Archives of Internal Medicine 11/2007; 167(19):2128-35. DOI:10.1001/archinte.167.19.2128 · 13.25 Impact Factor