Human immunodeficiency virus counseling and testing practices among North Carolina providers.

Authors

Troccoli K, Pollard H, McMahon M, et al. 

Institution

American College of Obstetricians and Gynecologists, Washington, DC, USA. ktroccoli@teenpregnancy.org

Source

Obstet Gynecol 2002 Sep; 100(3) :420-7.

Abstract

OBJECTIVE
To estimate the percentage of prenatal care providers who offer human immunodeficiency virus (HIV) testing to pregnant women, investigate how strongly testing is encouraged, and explore testing barriers.
METHODS
Between January 2001 and March 2001, we sent surveys to 1381 prenatal care providers in North Carolina, comprised of obstetricians, family physicians who practice obstetrics, and nurse-midwives. A total of 653 questionnaires were returned.
RESULTS
Overall, 95.5% of providers who responded reported recommending HIV testing to all pregnant patients. Only 69.2% strongly recommend testing, with obstetricians (73.4%) and family physicians (70.1%) doing so at higher rates than nurse-midwives (55.9%). Almost all respondents (96.9%) strongly recommend testing for women they perceive to be high risk, whereas 39.7% strongly recommend testing to women who have had an HIV test in the past 6 months. When women refuse testing, 48.1% of practitioners inquire about the reason, and 28.2% reoffer the test at a future prenatal appointment. The most significant testing barriers were treating an HIV-positive woman (18.4%) and informing a patient she is HIV positive (14.8%). Respondents report that low literacy and culturally appropriate patient education materials would be most helpful to them.
CONCLUSION
Among respondents, most prenatal care providers report that they recommend HIV testing to all pregnant women. However, many respondents base their decision about how strongly to recommend HIV testing on an assessment of the woman's risk for HIV exposure. Significant barriers to offering HIV testing were associated with managing an HIV-positive patient. Providers were most in need of patient education materials.

Mesh

AIDS Serodiagnosis
Adult
Attitude of Health Personnel
Counseling
Female
HIV Infections
Health Care Surveys
Health Personnel
Humans
Infectious Disease Transmission, Vertical
Mass Screening
North Carolina
Patient Education as Topic
Physician's Practice Patterns
Pregnancy
Prenatal Care
Probability
Questionnaires
Sexually Transmitted Diseases

Language

eng

Pub Type(s)

Journal Article

PubMed ID

12220759