Disparities in Prenatal HIV Testing: Evidence for Improving Implementation of CDC Screening Guidelines

Overview

Journal J Natl Med Assoc

Publisher Elsevier

Specialty General Medicine

Date 2005 Aug 6

PMID 16080457

Citations 5

Authors

Deborah N Pearlman

Abigail R Averbach

Sally Zierler

Kevin Cranston

Affiliations

Soon will be listed here.

Abstract

Objectives: We investigated the within-group and between-group variation in prenatal HIV testing in a sample of low-income pregnant and recently postpartum women.

Methods: Multivariable linear regression was used to estimate proportional differences in prenatal HIV testing for the total sample and stratified by race.

Results: In bivariate analyses, race and site of care jointly affected the probability of being tested. Hispanic women had the highest probability of being tested in public practice settings but relative to white women, black women had a higher probability of being tested in public and private practice settings. Predictors of prenatal HIV testing differed by race. Receiving prenatal care in a community health center or hospital outpatient clinic increased the probability of testing for Hispanics. Being a recent victim of intimate partner violence was associated with less frequent testing for blacks. Positive beliefs about HIV screening, while significant for blacks and Hispanics, was the only factor associated with testing for whites.

Conclusion: Our data suggest that racial biases may be influencing providers' approach to testing, rather than CDC's 2001 guidelines for HIV screening of pregnant women. Study findings are being used to modify social marketing campaigns and improve provider trainings regarding prenatal HIV testing.

Citing Articles

Innovation and implementation determinants of HIV testing and linkage-to-care in the U.S.: a systematic review.

Zamantakis A, Merle J, Queiroz A, Zapata J, Deskins J, Pachicano A Implement Sci Commun. 2024; 5(1):111.

PMID: 39380128 PMC: 11462864. DOI: 10.1186/s43058-024-00638-0.

Messaging matters: achieving equity in the HIV response through public health communication.

Taggart T, Ritchwood T, Nyhan K, Ransome Y Lancet HIV. 2021; 8(6):e376-e386.

PMID: 34087098 PMC: 8363183. DOI: 10.1016/S2352-3018(21)00078-3.

Gender-based violence and engagement in biomedical HIV prevention, care and treatment: a scoping review.

Leddy A, Weiss E, Yam E, Pulerwitz J BMC Public Health. 2019; 19(1):897.

PMID: 31286914 PMC: 6615289. DOI: 10.1186/s12889-019-7192-4.

Routine prenatal HIV testing: women's concerns and their strategies for addressing concerns.

Rothpletz-Puglia P, Storm D, Burr C, Samuels D Matern Child Health J. 2011; 16(2):464-9.

PMID: 21301944 PMC: 3262134. DOI: 10.1007/s10995-011-0754-4.

Characteristics of HIV-infected children recently diagnosed in Paris, France.

Macassa E, Burgard M, Veber F, Picard C, Neven B, Malhaoui N Eur J Pediatr. 2006; 165(10):684-7.

PMID: 16799798 DOI: 10.1007/s00431-006-0091-6.

References

. HIV testing among pregnant women--United States and Canada, 1998-2001. MMWR Morb Mortal Wkly Rep. 2002; 51(45):1013-6. View

Pearlman D, Zierler S, Gjelsvik A, Verhoek-Oftedahl W . Neighborhood environment, racial position, and risk of police-reported domestic violence: a contextual analysis. Public Health Rep. 2003; 118(1):44-58. PMC: 1497500. DOI: 10.1093/phr/118.1.44. View

Saltzman L, Johnson C, Gilbert B, Goodwin M . Physical abuse around the time of pregnancy: an examination of prevalence and risk factors in 16 states. Matern Child Health J. 2003; 7(1):31-43. DOI: 10.1023/a:1022589501039. View

. Advancing HIV prevention: new strategies for a changing epidemic--United States, 2003. MMWR Morb Mortal Wkly Rep. 2003; 52(15):329-32. View

Kline M, OConnor K . Disparity between pediatricians' knowledge and practices regarding perinatal human immunodeficiency virus counseling and testing. Pediatrics. 2003; 112(5):e367. DOI: 10.1542/peds.112.5.e367. View

Schuman P, Jones T, Ohmit S, Marbury C, Laken M . Voluntary HIV counseling and testing of pregnant women--an assessment of compliance with Michigan public health statutes. MedGenMed. 2004; 6(2):52. PMC: 1395799. View

OCampo P, Gielen A, Faden R, Xue X, Kass N, Wang M . Violence by male partners against women during the childbearing year: a contextual analysis. Am J Public Health. 1995; 85(8 Pt 1):1092-7. PMC: 1615813. DOI: 10.2105/ajph.85.8_pt_1.1092. View

Healton C, Messeri P, Abramson D, Howard J, Sorin M, Bayer R . A balancing act: the tension between case-finding and primary prevention strategies in New York State's voluntary HIV counseling and testing program in women's health care settings. Am J Prev Med. 1996; 12(4 Suppl):53-60. View

OCampo P, de Boer M, Faden R, Kass N, Gielen A, Barbacci M . Confirmation of self-report of HIV testing among a cohort of pregnant women. J Clin Epidemiol. 1997; 50(1):57-61. DOI: 10.1016/s0895-4356(96)00301-0. View

10.

Bachman R, Coker A . Police involvement in domestic violence: the interactive effects of victim injury, offender's history of violence, and race. Violence Vict. 1995; 10(2):91-106. View

11.

Kelly S . Geographic concentration of violence between intimate partners. Public Health Rep. 1997; 112(2):135-41. PMC: 1381860. View

12.

Gfroerer J, Lessler J, Parsley T . Studies of nonresponse and measurement error in the national household survey on drug abuse. NIDA Res Monogr. 1997; 167:273-95. View

13.

. Prenatal discussion of HIV testing and maternal HIV testing--14 states, 1996-1997. MMWR Morb Mortal Wkly Rep. 1999; 48(19):401-4. View

14.

Colley Gilbert B, Johnson C, Morrow B, Gaffield M, Ahluwalia I . Prevalence of selected maternal and infant characteristics, Pregnancy Risk Assessment Monitoring System (PRAMS), 1997. MMWR CDC Surveill Summ. 1999; 48(5):1-37. View

15.

Ethier K, Ickovics J, Fernandez M, Wilson T, Royce R, Koenig L . The Perinatal Guidelines Evaluation Project HIV and Pregnancy Study: overview and cohort description. Public Health Rep. 2002; 117(2):137-47. PMC: 1497420. DOI: 10.1093/phr/117.2.137. View

16.

Joo E, Carmack A, Kelly C . Implementation of guidelines for HIV counseling and voluntary HIV testing of pregnant women. Am J Public Health. 2000; 90(2):273-6. PMC: 1446152. DOI: 10.2105/ajph.90.2.273. View

17.

Cunradi C, Caetano R, Clark C, Schafer J . Neighborhood poverty as a predictor of intimate partner violence among White, Black, and Hispanic couples in the United States: a multilevel analysis. Ann Epidemiol. 2000; 10(5):297-308. DOI: 10.1016/s1047-2797(00)00052-1. View

18.

Fernandez M, Wilson T, Ethier K, Walter E, Gay C, Moore J . Acceptance of HIV testing during prenatal care. Perinatal Guidelines Evaluation Project. Public Health Rep. 2001; 115(5):460-8. PMC: 1308602. DOI: 10.1093/phr/115.5.460. View

19.

Royce R, Walter E, Fernandez M, Wilson T, Ickovics J, Simonds R . Barriers to universal prenatal HIV testing in 4 US locations in 1997. Am J Public Health. 2001; 91(5):727-33. PMC: 1446691. DOI: 10.2105/ajph.91.5.727. View

20.

Jasinski J, Kantor G . Pregnancy, stress and wife assault: ethnic differences in prevalence, severity, and onset in a national sample. Violence Vict. 2001; 16(3):219-32. View