Barriers to universal prenatal HIV testing in 4 US locations in 1997.

Journal Article (Journal Article;Multicenter Study)

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.

Full Text

Duke Authors

Cited Authors

  • Royce, RA; Walter, EB; Fernandez, MI; Wilson, TE; Ickovics, JR; Simonds, RJ; Perinatal Guidelines Evaluation Project,

Published Date

  • May 2001

Published In

Volume / Issue

  • 91 / 5

Start / End Page

  • 727 - 733

PubMed ID

  • 11344880

Pubmed Central ID

  • PMC1446691

International Standard Serial Number (ISSN)

  • 0090-0036

Digital Object Identifier (DOI)

  • 10.2105/ajph.91.5.727


  • eng

Conference Location

  • United States