Appendix J Human Immunodeficiency Virus Antibody Testing Among Women 15–44: Results from the 1995 National Survey of Family Growth

Maria Hewitt

National estimates of the use of HIV tests among women of reproductive-age are available from the 1995 National Survey of Family Growth (NSFG) conducted by the National Center for Health Statistics (NCHS, 1997). As part of this survey, 10,847 women were interviewed in their homes from January to October 1995. The survey response rate was 79%. Interviews lasted an average of 103 minutes and covered the following topics: pregnancy and birth history, marriage and cohabitation history, sexual partner history, contraceptive use, diseases related to fertility (e.g., pelvic inflammatory disease, sexually transmitted diseases [STDs]), HIV-related behaviors, and use of HIV tests. To ensure the confidentiality of responses to potentially sensitive questions, a small part of the interview was self-administered. Women listened over headphones to questions on topics such as abortion, sex partner history, and HIV-related behaviors and entered answers directly into laptop computers. This technique, called audio-CASI (computer-assisted self-interviewing), improves reporting of sensitive behaviors (NCHS, 1997).

The tables that follow show HIV test use among women of childbearing age by selected sociodemographic characteristics, pregnancy status, and HIV risk status. HIV test use is shown for women who were pregnant at the time of the interview, had completed a pregnancy in the last year, or had received pre- or postnatal care within the last year (1,472 women representing 13% of the population were pregnant, or recently pregnant using these criteria; these women are referred to as "pregnant" in the tables).

HIV test use is also shown by HIV risk status. A total of 691 women representing an estimated 6% of the population report specific risk behaviors (e.g., injection drug use or sex with an injection drug user), or a moderate to high self-perceived



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--> Appendix J Human Immunodeficiency Virus Antibody Testing Among Women 15–44: Results from the 1995 National Survey of Family Growth Maria Hewitt National estimates of the use of HIV tests among women of reproductive-age are available from the 1995 National Survey of Family Growth (NSFG) conducted by the National Center for Health Statistics (NCHS, 1997). As part of this survey, 10,847 women were interviewed in their homes from January to October 1995. The survey response rate was 79%. Interviews lasted an average of 103 minutes and covered the following topics: pregnancy and birth history, marriage and cohabitation history, sexual partner history, contraceptive use, diseases related to fertility (e.g., pelvic inflammatory disease, sexually transmitted diseases [STDs]), HIV-related behaviors, and use of HIV tests. To ensure the confidentiality of responses to potentially sensitive questions, a small part of the interview was self-administered. Women listened over headphones to questions on topics such as abortion, sex partner history, and HIV-related behaviors and entered answers directly into laptop computers. This technique, called audio-CASI (computer-assisted self-interviewing), improves reporting of sensitive behaviors (NCHS, 1997). The tables that follow show HIV test use among women of childbearing age by selected sociodemographic characteristics, pregnancy status, and HIV risk status. HIV test use is shown for women who were pregnant at the time of the interview, had completed a pregnancy in the last year, or had received pre- or postnatal care within the last year (1,472 women representing 13% of the population were pregnant, or recently pregnant using these criteria; these women are referred to as "pregnant" in the tables). HIV test use is also shown by HIV risk status. A total of 691 women representing an estimated 6% of the population report specific risk behaviors (e.g., injection drug use or sex with an injection drug user), or a moderate to high self-perceived

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--> risk of being HIV-infected themselves or of having had sex with someone infected with HIV. HIV test use is shown in three ways: (1) "all HIV tests" includes self-reported HIV tests and any mentions of blood donation since 1985; (2) "any self-reported HIV test" excludes mentions of blood donation when the respondent does not specifically report having had an HIV test; and (3) "HIV test in last 12 months" is limited to self-reported HIV testing. All rates and population counts are weighted to provide national estimates. Variance estimates for these HIV test use rates and logistic regression model parameters were calculated using the Taylor series method taking into account the complex design of the survey (STATA statistical software). Preliminary Findings Self-Reported HIV Test Use Among Reproductive-Age Women From 1990 to 1995, self-reported HIV test use increased from 26% to 35% among reproductive-age women (Table J.1). In 1995, pregnant women were almost twice as likely as non-pregnant women to have been tested for HIV (60% versus 31%) (Table J.2). Women at high-risk for HIV are almost twice as likely as those at low risk to have been tested for HIV (64% versus 33%). Similarly, there are high rates of HIV testing among women reporting at least one STD in their lifetime (53%) and women reporting six or more lifetime sex partners (49%) (Table J.3). Nearly nine of ten pregnant women (87%) at high risk for HIV report having been tested for HIV. HIV testing occurred within the year for two-thirds of high-risk pregnant women (67%) (Table J.4). Location of Self-Reported HIV Tests The most common sites of HIV testing among reproductive-age women are private doctor's offices or heath maintenance organizations (HMOs) (46%), public health department or other clinics (27%), and hospitals (16%). Teenagers, those with lower educational attainment, and the poor are more likely to use public health department and other clinics than private doctor's offices or HMOs (Table J.5). Pregnant women are more likely than non-pregnant women to have been tested in the last 12 months at a doctor's office or HMO (62% versus 48%) (Table J.8).

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--> TABLE J.1 Number of Women 15–44 Years of Age and Percent Ever Tested for HIV, by Source of Test Information and Selected Demographic Characteristics: United States, 1990 and 1995a       Percent Ever Tested   Number of Women (thousands) Self-Reported Testsb (standard error) All Testsc (standard error) Characteristic 1990 1995 1990 1995 1990 1995 All womend 58,381 60,201 25.6 34.7 (0.6) 34.9 47.9 (0.6) Race and ethnicity Hispanic 5,547 6,703 23.8 38.9 (1.8) 29.8 46.6 (1.5) Black, not Hispanic 7,526 8,210 28.5 45.5 (1.3) 34.8 50.8 (1.4) White, not Hispanic 42,836 42,521 25.4 32.2 (0.7) 35.8 48.1 (0.7) Education Less than 12 years 5,618 15,151 24.6 29.9 (1.2) 31.0 36.1 (1.2) 12 years 17,247 19,987 23.1 35.1 (0.9) 31.3 47.5 (1.0) 13 years or more 27,033 24,763 28.6 37.3 (0.9) 39.9 55.6 (0.86) Marital status Never married 20,123 22,679 26.0 31.1 (0.9) 35.7 44.2 (0.9) Married 31,417 29,673 23.6 34.2 (0.8) 32.5 48.4 (0.8) Formerly married 6,841 7,849 33.5 46.9 (1.3) 43.4 56.8 (1.3)

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--> Age 15–19 8,483 8,924 21.5 20.9 (1.3) 28.7 29.0 (1.4) 20–24 9,154 8,946 27.0 40.3 (1.4) 40.8 55.5 (1.5) 25–29 10,637 9,795 33.4 44.6 (1.4) 40.9 60.1 (1.4) 30–34 11,091 10,982 27.5 42.0 (1.5) 37.1 54.6 (1.4) 35–39 10,111 11,297 22.0 33.3 (1.3) 31.5 46.0 (1.3) 40–44 8,905 10,014 20.3 26.4 (1.0) 28.5 41.3 (1.2) Residence in metropolitan area MSA, central city 12,727 18,551 31.9 39.8 (0.9) 39.9 51.3 (0.9) MSA, other 29,981 29,303 26.1 33.5 (0.8) 36.4 47.7 (0.8) Non-MSA 11,979 12,348 21.4 30.0 (1.5) 32.4 43.2 (1.5) Region Northeast 11,226 11,496 28.2 32.1 (1.2) 36.9 45.2 (1.5) South 18,603 20,241 28.0 38.9 (1.1) 39.5 51.6 (1.0) Midwest 14,453 14,525 23.8 29.4 (1.1) 34.0 44.3 (1.2) West 10,405 13,938 25.4 36.3 (1.5) 33.5 48.5 (1.3) Poverty-level income 0–149% 7,918 13,588 28.1 41.8 (1.2) 35.5 49.6 (1.2) 150% or more 41,980 46,613 25.9 32.6 (0.7) 36.0 47.4 (0.7) NOTE: MSA = metropolitan statistical area. a Data from 1990 from Wilson, 1993. b Includes only test reported in response to the question: "Have you ever had your blood tested for infection with the AIDS virus?" c Category includes all tests for HIV infection, including those done in connection with blood donation (i.e., all reporting a blood donation since March 1985). d Includes women classified as "other" races, not shown separately because of small sample size.

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--> TABLE J.2 Number of Women 15–44 Years of Age by Pregnancy Status, and Percent Tested for HIV, by Selected Demographic Characteristics: United States, 1995a   Number of Women (thousands) HIV Test Last 12 Months (percent/standard error) Any Self-Reported Testsb (percent/standard error) Characteristic Pregnant Not Pregnant Pregnant Not Pregnant Pregnant Not Pregnant All womenc 7,789 52,141 41.9 (1.4) 13.7 (0.4) 59.9 (1.5) 30.9 (0.6) Race and ethnicity Hispanic 1,245 5,448 47.4 (4.2) 16.1 (1.2) 60.3 (4.1) 33.9 (1.8) Black, not Hispanic 1,166 7,032 55.5 (3.1) 24.3 (1.2) 71.4 (2.7) 41.2 (1.4) White, not Hispanic 5,020 37,268 37.8 (1.8) 11.5 (0.5) 57.5 (2.1) 28.7 (0.7) Education Less than 12 years 2,025 13,081 54.5 (3.0) 13.0 (0.7) 69.2 (2.8) 23.8 (1.0) 12 years 2,655 17,250 42.1 (2.3) 14.0 (0.7) 59.4 (2.8) 31.3 (0.9) 13 years or more 3,075 21,545 33.6 (2.0) 13.8 (0.6) 54.2 (2.2) 34.9 (0.9) Marital status Never married 2,039 20,593 51.3 (2.8) 15.7 (0.7) 65.4 (2.8) 27.7 (0.9) Married 5,024 24,457 36.1 (1.8) 10.2 (0.6) 55.2 (1.8) 29.8 (0.8) Formerly married 726 7,092 55.8 (4.9) 19.8 (1.1) 77.1 (3.9) 43.8 (1.3) Age 15–19 957 7,953 55.3 (4.0) 9.9 (0.9) 68.7 (4.2) 15.2 (1.1) 20–24 1,813 7,086 45.3 (3.1) 18.6 (1.2) 61.2 (3.2) 34.9 (1.5) 25–29 2,293 7,443 39.8 (2.9) 18.7 (1.2) 58.1 (2.8) 40.4 (1.6)

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--> 30–34 1,802 9,126 40.1 (2.9) 14.5 (0.9) 61.5 (3.1) 38.1 (1.5) 35–39 710 10,544 28.9 (4.2) 13.0 (0.8) 47.5 (5.0) 32.4 (1.3) 40–44 213 9,748 33.8 (8.2) 9.6 (0.8) 55.5 (8.2) 25.8 (1.0) Residence in metropolitan area MSA, central city 2,617 15,891 48.1 (2.6) 16.8 (0.8) 66.7 (2.4) 35.3 (0.9) MSA, other 3,631 25,499 38.5 (2.0) 12.9 (0.6) 55.9 (2.3) 30.2 (0.8) Non-MSA 1,542 10,750 39.4 (3.5) 11.0 (0.8) 57.8 (4.1) 26.0 (1.4) Region Northeast 1,431 10,009 40.2 (3.2) 12.9 (0.9) 58.6 (2.7) 28.3 (1.3) South 2,587 17,569 51.6 (2.8) 16.0 (0.8) 70.3 (2.3) 34.3 (1.1) Midwest 1,870 12,553 34.3 (2.3) 10.6 (0.8) 51.9 (3.2) 25.9 (1.1) West 1,901 12,011 37.5 (3.2) 14.2 (0.9) 54.8 (3.7) 33.3 (1.4) Poverty-level income 0–149% 2,306 11,250 51.1 (2.5) 17.6 (1.0) 66.5 (2.3) 36.7 (1.3) 150% or more 5,483 40,892 38.0 (1.7) 12.6 (0.5) 57.1 (1.8) 29.3 (0.7) NOTE: MSA = metropolitan statistical area. a A total of 1,472 survey respondents reported that they either were pregnant at the time of the interview (430), had completed a pregnancy within 12 months of the interview (1,039), or had received pre- or postnatal care in the last 12 months (1,140). Women referred to as ''pregnant" in this table are women who were pregnant, or recently pregnant, at the time of the interview. b Includes only tests reported in response to the question: "Have you ever had your blood tested for infection with the AIDS virus?" Mentions of blood donation since 1985 are not included. c Includes women classified as "other" races, not shown separately because of small sample size.

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--> TABLE J.3 Number of Women 15–44 Years of Age Reporting AIDS Risk Behaviors, and Percent Ever Tested for HIV: United States, 1995     Percent Ever Tested   Characteristic Number of Women (thousands) Any Self-Reported Testa (standard error) All Testsb (standard error) All women 60,201 34.7 (0.6) 47.9 (0.6) HIV risk Moderate/high HIV riskc 3,672 63.9 (2.0) 68.5 (1.8) Low HIV risk 56,528 32.8 (0.6) 46.6 (0.6) STD history At least one STD reported in lifetimed 6,218 53.2 (1.8) 66.2 (1.7) No STD in lifetime 53,983 32.6 (0.7) 45.8 (0.6) Number of sexual partners in lifetime None 6,196 6.8 (0.8) 20.0 (1.6) One 13,838 25.3 (1.0) 39.1 (1.1) Two–five 22,655 37.5 (0.9) 50.6 (1.0) Six–more 16,209 48.9 (1.0) 62.2 (1.0) a Includes only tests reported in response to the question: "Have you ever had your blood tested for infection with the AIDS virus?" b Category includes all tests for HIV infection, including those done in connection with blood donation (i.e., all reporting a blood donation since March 1985). c Women reported whether they had a high, moderate, low, or no chance of being currently HIV-infected and whether they had a high, moderate, low, or no chance of having had sex with someone HIV-infected. Anyone indicating "high" or "moderate" on either question was categorized as at HIV-risk. In addition, during the audio-CASI portion of the interview, women reported whether they injected drugs in the last year, shared needles in the last year, or had a sex partner in the last year who had male partners, injected drugs, or shared needles. Any respondents answering yes to these questions were also categorized as at-risk. Using these criteria, 6% of women were categorized as at-risk (i.e., either self-identified as at-risk or reporting risk behaviors). d Includes mention of gonorrhea, chlamydia, syphilis, genital warts, and genital herpes. Reason for Self-Reported HIV Tests The most common reason for HIV testing among reproductive-age women is "just to find out" (36%), as part of prenatal or pregnancy care (25%), and for a hospital procedure, referral by a doctor or other health provider contact (16%) (Table J.6). Two-thirds of pregnant women (67%) cite pregnancy as the reason for HIV tests performed within the last 12 months (Table J.8).

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--> Source of Referral for Self-Reported HIV Tests When asked whose idea it was to get tested, 42% of reproductive-age women report a doctor or other health care provider, 39% report self, and 7% report an insurer (Table J.7). Pregnant women are more than twice as likely as non-pregnant women to report that they were recently tested for HIV upon the recommendation of a health care provider (70% versus 30%) (Table J.8). Factors Contributing to Test Use among Pregnant and Non-Pregnant Women According to multivariate analyses, different factors are predictive of HIV test use for pregnant and non-pregnant women. Among women who are not pregnant, being at HIV risk, African American, poor, living in a metropolitan area, being age 20–39, highly educated, and having been formerly married increase HIV test use. Decreased HIV test use occurs among teenagers and residents of the Northeast and Midwest. Being at HIV risk triples the odds of HIV test use among non-pregnant women (Table J.9). Among pregnant women, many of the sociodemographic predictors of HIV testing observed among non-pregnant women lose significance (i.e., age, race, poverty, and metropolitan area residence). This suggests that pregnancy is serving as a triggering event for testing, irrespective of the woman's characteristics. The role of education is reversed for pregnant women. Here, lower educational attainment is predictive of HIV testing. Different geographic patterns emerge for pregnant women, with residents of the South more likely to be tested than residents of other areas. Being at HIV risk quadruples the odds of HIV testing among pregnant women (Table J.9). References National Center for Health Statistics. Report of final mortality statics, 1995. Monthly Vital Statistics Report 1997; 45(11:Suppl 2). Wilson JB. Human immunodeficiency virus antibody testing in women 15–44 years of age: United States, 1990. Advance Data from Vital and Health Statistics. Number 238, Hyattsville, Md.: National Center for Health Statistics, 1993.

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--> TABLE J.4 Number of Women 15–44 Years of Age by Pregnancy Status and Percent Tested for HIV by Selected Measures of HIV Risk: United States, 1995a   Number of Women (thousands) HIV Test Last 12 Months (percent/standard error) Any Self-Reported Testb (percent/standard error) Characteristic Pregnant Not Pregnant Pregnant Not Pregnant Pregnant Not Pregnant All women 7,789 52,141 41.9 (1.4) 13.7 (0.4) 59.9 (1.5) 30.9 (0.6) HIV risk Report HIV-riskc 595 3,064 66.7 (4.5) 32.3 (2.4) 87.2 (3.6) 59.3 (2.3) No report of HIV risk 7,194 49,078 39.9 (1.5) 12.5 (0.4) 57.6 (1.6) 29.1 (0.6) STD history At least 1 STD reported in lifetimed 1,022 5,162 44.3 (4.4) 21.1 (1.5) 69.3 (3.9) 50.0 (2.0) No STD in lifetime 6,767 46,979 41.6 (1.5) 12.9 (0.5) 58.5 (1.5) 28.8 (0.7)

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--> Number of sexual partners in lifetime One 2,063 11,672 34.4 (2.7) 8.4 (0.7) 48.6 21.1 (0.9) Two–five 3,416 19,142 43.7 (2.6) 15.0 (0.7) 60.6 33.4 (0.9) Six-more 2,090 14,048 45.5 (2.8) 20.9 (0.9) 68.8 45.9 (1.0) a A total of 1,472 survey respondents reported that they either were pregnant at the time of the interview (430), had completed a pregnancy within 12 months of the interview (1,039), or had received pre- or postnatal care in the last 12 months (1,140). Women referred to as "pregnant" in this table are to women who were pregnant, or recently pregnant, at the time of the interview. b Includes only tests reported in response to the question: "Have you ever had your blood tested for infection with the AIDS virus?" c Women reported whether they had a high, moderate, low, or no change of being currently HIV-infected and whether they had a high, moderate, low, or no chance of having had sex with someone HIV-infected. Anyone indicating "high" or ''moderate" on either question was categorized as at HIV-risk. In addition, during the audio-CASI portion of the interview, women reported whether they injected drugs in last year, shared needles in the last year, or had a sex partner in the last year who had male partners, injected drugs, or shared needles. Any respondents answering yes to these questions were also categorized as at-risk. Using these criteria, 6% of women were categorized as at-risk (i.e., either self-identified as at-risk or reporting risk behaviors). d Includes mention of gonorrhea, chlamydia, syphilis, genital warts, and genital herpes.

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--> TABLE J.5 Number of Women 15–44 Years of Age Self-Reporting Test for HIV and Percent Tested at Specific Locations for Most Recent Test, by Selected Demographic Characteristics: United States, 1995     Location of Most Recent HIV Test (percent/standard error) Characteristic Number of Women (thousands) Private Doctor's Office or HMO Public Health or Other Clinica Hospital or Emergency Room Other Locationb All womenc 20,889 46.4 (0.1) 26.8 (0.9) 15.9 (0.7) 10.9 (0.6) Race and ethnicity Hispanic 2,606 41.8 (2.0) 36.6 (2.2) 14.1 (1.6) 7.6 (1.2) Black, not Hispanic 3,734 40.1 (1.8) 38.6 (1.8) 15.0 (1.2) 6.3 (0.9) White, not Hispanic 13,675 49.1 (1.3) 21.8 (1.1) 16.6 (0.9) 12.5 (0.8) Education Less than 12 years 4,533 36.7 (1.9) 41.3 (1.9) 16.8 (1.4) 5.2 (0.8) 12 years 7,014 48.1 (1.5) 26.0 (1.3) 15.9 (1.1) 10.0 (0.9) 13 years or more 9,244 49.8 (1.3) 20.2 (1.2) 15.6 (1.0) 14.4 (1.1) Marital status Never married 7,058 39.9 (1.8) 38.3 (1.7) 13.6 (1.2) 8.2 (0.9) Married 10,149 50.9 (1.3) 18.6 (1.0) 16.6 (1.0) 13.9 (0.9) Formerly married 3,682 46.3 (2.3) 27.7 (1.9) 18.3 (1.5) 7.7 (1.3)

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--> Age 15–19 1,864 39.2 (2.9) 41.0 (2.7) 14.3 (2.1) 5.5 (1.2) 20–24 3,607 41.9 (2.3) 38.3 (2.1) 13.3 (1.6) 6.5 (1.2) 25–29 4,372 51.6 (2.0) 25.7 (1.9) 13.0 (1.6) 9.7 (1.1) 30–34 4,614 51.8 (1.8) 22.6 (1.6) 14.8 (1.4) 10.9 (1.2) 35–39 3,763 44.6 (2.1) 21.5 (1.7) 20.6 (1.6) 13.2 (1.6) 40–44 2,643 41.6 (2.3) 18.2 (2.0) 20.8 (1.9) 19.4 (1.9) Residence in metropolitan area MSA, central city 7,378 44.1 (1.5) 31.7 (1.5) 15.6 (1.0) 8.6 (1.0) MSA, other 9,802 48.7 (1.3) 22.6 (1.1) 15.5 (0.9) 13.2 (0.8) Non-MSA 3,709 44.8 (2.5) 28.4 (2.2) 17.8 (1.9) 9.0 (1.5) Region Northeast 3,686 42.5 (2.7) 25.4 (2.7) 18.2 (1.6) 13.8 (1.7) South 7,876 46.4 (1.5) 29.4 (1.4) 15.3 (1.0) 8.8 (0.8) Midwest 4,269 44.6 (2.5) 24.4 (1.8) 20.2 (2.0) 10.8 (1.5) West 5,058 50.7 (1.4) 25.8 (1.5) 11.6 (1.0) 11.9 (1.0) Poverty-level income 0–149% 5,685 36.5 (1.5) 41.1 (1.7) 16.1 (1.2) 6.4 (1.0) 150% or more 15,204 50.1 (1.1) 21.5 (1.0) 15.9 (0.8) 12.5 (0.7) NOTE: MSA = metropolitan statistical area. a Includes community clinics, family planning, public health, and other clinics. b Includes other places such as school or college, military facility, home, job site, laboratory, or donation site. c Includes women classified as "other" races, not shown separately because of small sample size.

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--> TABLE J.6 Number of Women 15–44 Years of Age Self-Reporting Any Test for HIV and Percent Tested by Reason for the Last Test, by Selected Demographic Characteristics: United States, 1995     Reason for Last HIV Test (percent/standard error)     Characteristic Number of Women (thousands) HIV Test Only Reason for Visit Pregnant, Prenatal Care Hospital Procedure/ Referred by Doctora Health/Life Insurance Other Reasonb All Womenc 20,889 35.8 (0.8) 25.0 (0.8) 15.5 (0.7) 8.5 (0.5) 15.2 (0.7) Race and ethnicity Hispanic 2,605 34.9 (2.5) 29.5 (2.5) 13.3 (1.4) 8.4 (1.3) 13.9 (1.6) Black, not Hispanic 3,735 46.3 (1.6) 20.5 (1.4) 18.1 (1.2) 5.4 (0.8) 9.7 (1.0) White, not Hispanic 13,674 33.6 (1.1) 25.3 (1.0) 15.3 (0.9) 9.6 (0.7) 16.2 (0.8) Education Less than 12 years 4,533 39.2 (1.8) 29.5 (1.6) 17.4 (1.3) 2.0 (0.5) 11.9 (1.3) 12 years 7,015 36.6 (1.5) 27.8 (1.4) 15.4 (1.1) 7.6 (0.8) 12.6 (1.0) 13 years or more 9,245 33.3 (1.4) 20.8 (1.0) 14.7 (1.0) 12.4 (0.9) 18.8 (1.1) Marital status Never married 7,058 50.8 (1.5) 17.7 (1.2) 15.1 (1.2) 4.0 (0.5) 12.5 (1.1) Married 10,148 20.1 (1.1) 33.5 (1.3) 15.8 (0.9) 13.0 (0.9) 17.6 (1.0) Formerly married 3,682 50.3 (2.3) 15.7 (1.6) 15.3 (1.4) 4.9 (1.2) 13.8 (1.4)

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--> Age 15–19 1,866 47.3 (3.0) 24.3 (2.4) 16.3 (1.9) 1.5 (0.8) 10.6 (1.9) 20–24 3,606 40.2 (2.4) 32.8 (2.3) 10.5 (1.3) 3.0 (0.7) 13.5 (1.7) 25–29 4,373 36.3 (1.9) 31.5 (2.0) 12.4 (1.4) 6.9 (0.9) 13.0 (1.2) 30–34 4,614 28.8 (1.6) 29.1 (1.6) 15.9 (1.4) 10.8 (1.2) 15.5 (1.4) 35–39 3,765 33.0 (2.0) 17.5 (1.5) 20.3 (1.8) 11.9 (1.3) 17.3 (1.6) 40–44 2,644 37.0 (2.4) 7.8 (1.3) 19.5 (1.7) 15.1 (1.8) 20.5 (1.7) Residence in metropolitan area MSA, central city 7,377 39.5 (1.4) 24.5 (1.3) 15.3 (1.2) 6.6 (0.7) 14.1 (1.1) MSA, other 9,803 33.7 (1.2) 24.7 (1.1) 14.9 (1.0) 10.2 (0.8) 16.6 (0.9) Non-MSA 3,708 33.8 (2.3) 26.7 (2.3) 17.7 (1.7) 8.0 (1.3) 13.9 (1.6) Region Northeast 3,686 38.3 (1.9) 22.1 (1.9) 11.3 (1.2) 13.3 (1.5) 15.0 (1.5) South 7,875 35.6 (1.3) 26.0 (1.4) 18.5 (1.0) 6.5 (0.7) 13.3 (1.1) Midwest 4,268 30.5 (2.1) 26.8 (1.7) 16.6 (1.5) 8.2 (1.0) 17.9 (1.6) West 5,058 38.6 (1.6) 24.0 (1.4) 12.9 (1.7) 8.5 (0.9) 16.0 (1.3) Poverty-level income 0–149% 5,686 39.0 (1.7) 30.2 (1.6) 17.5 (1.4) 1.9 (0.4) 11.4 (1.2) 150% or more 15,204 34.6 (0.9) 23.1 (0.9) 14.8 (0.8) 11.0 (0.7) 16.6 (0.8) NOTE: MSA = metropolitan statistical area. a Includes being part of routine or general physical exam, and to start or renew birth control. b Includes being part of a marriage license application, for employment, because potentially exposed to HIV, for immigration or visa application, and for school or college. c Includes women classified as "other" races, not shown separately because of small sample size.

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--> TABLE J.7 Number of Women 15–44 Years of Age Self-Reporting Any Test for HIV and Percent Tested by Referral Source for the Last Test, by Selected Demographic Characteristics: United States, 1995     Referral source (percent/standard error) Characteristic Number of Women (thousands) Self Health Care Providera Insurer Otherb All womenc 20,889 39.3 (0.9) 42.4 (0.9) 7.3 (0.5) 10.9 (0.6) Race and ethnicity Hispanic 2,606 40.5 (2.5) 42.7 (2.2) 6.7 (1.0) 10.1 (1.1) Black, not Hispanic 3,734 44.0 (1.8) 44.2 (1.9) 4.0 (0.7) 7.7 (0.9) White, not Hispanic 13,675 38.2 (1.1) 41.9 (1.1) 8.5 (0.7) 11.4 (0.8) Education Less than 12 years 4,533 38.5 (1.8) 49.2 (1.7) 1.8 (0.5) 10.5 (1.2) 12 years 7,015 40.0 (1.6) 44.4 (1.5) 6.5 (0.7) 9.1 (0.9) 13 years or more 9,244 38.9 (1.2) 37.8 (1.2) 10.7 (0.9) 12.5 (0.9) Marital status Never married 7,057 49.7 (1.5) 36.3 (1.6) 3.2 (0.5) 10.7 (1.0) Married 10,148 26.8 (1.2) 49.9 (1.4) 11.5 (0.8) 11.8 (0.8) Formerly married 3,683 54.0 (2.2) 33.2 (2.0) 3.8 (1.0) 9.0 (1.3) Age 15–19 1,865 42.8 (3.0) 41.9 (3.0) 1.5 (0.8) 13.9 (2.3) 20–24 3,606 41.9 (2.2) 44.8 (2.3) 2.9 (0.7) 10.5 (1.6) 25–29 4,372 39.2 (2.1) 46.9 (2.3) 5.9 (0.9) 8.0 (1.0) 30–34 4,615 35.7 (1.7) 45.3 (1.8) 9.0 (1.0) 10.0 (1.0) 35–39 3,764 37.9 (2.3) 39.5 (2.2) 9.8 (1.3) 12.8 (1.4) 40–44 2,643 41.8 (2.4) 31.5 (2.0) 13.7 (1.7) 13.0 (1.7) Residence in metropolitan area MSA, central city 7,378 42.4 (1.4) 41.6 (1.4) 5.9 (0.7) 10.1 (1.0) MSA, other 9,803 38.8 (1.3) 40.9 (1.3) 8.7 (0.7) 11.5 (0.8) Non-MSA 3,708 34.6 (2.3) 47.9 (2.1) 6.6 (1.2) 10.9 (1.4) Region Northeast 3,687 43.8 (2.1) 35.0 (2.0) 10.1 (1.2) 11.2 (1.3) South 7,875 37.4 (1.3) 47.1 (1.4) 5.5 (0.7) 9.9 (0.9) Midwest 4,268 33.2 (1.9) 45.3 (1.9) 7.4 (1.0) 14.0 (1.4) West 5,057 44.2 (2.1) 38.0 (1.7) 8.1 (0.9) 9.8 (1.1) Poverty-level income 0–149% 5,685 40.3 (1.6) 48.4 (1.6) 1.5 (0.4) 9.7 (1.1) 150% or more 15,203 39.0 (1.0) 40.1 (1.0) 9.5 (0.6) 11.4 (0.7) NOTE: MSA = metropolitan statistical area. a Includes women for whom the idea for testing came from a doctor, health department, and hospital or medical policy. b Includes employer or school, government policy, sexual partner, and family or friends. c Includes women classified as "other" races, not shown separately because of small sample size.

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--> TABLE J.8 Number of Women 15–44 Years of Age by Pregnancy Status and Percent Tested for HIV In Last 12 Months by Location of Testing, Reason for Test, and Source of Referral for HIV Test: United States, 1995a   HIV Test Last 12 Months (percent/standard error)   Pregnant (n = 3,266) Not Pregnant (n = 7,139) Location of test     Private doctor's office or HMO 62.0 (2.1) 48.4 (1.6) Public health or other clinicb 28.8 (1.9) 30.2 (1.5) Hospital or emergency room 7.2 (1.2) 11.1 (1.0) Other locationsc 2.0 (0.6) 10.4 (1.0) Total 100.0 100.0 Reason for test (n = 3,265) (n = 7,139) HIV test only reason for test 19.3 (1.8) 49.5 (1.5) Pregnant, prenatal care 66.9 (2.1) 3.4 (0.5) Hospital procedure/doctor referrald 7.3 (1.1) 22.0 (1.4) Health/life insurance 2.9 (0.8) 9.1 (0.8) Other reasone 3.6 (0.8) 16.0 (1.1) Total 100.0 100.0 Source of referral for test (n = 3,265) (n = 7,139) Self 24.6 (1.8) 51.0 (1.5) Health care providerf 70.0 (2.0) 30.1 (1.4) Insurer 2.3 (0.7) 7.6 (0.8) Otherg 3.1 (0.8) 11.3 (1.1) Total 100.0 100.0 a A total of 1,472 survey respondents reported that they either were pregnant at the time of the interview (430), had completed a pregnancy within 12 months of the interview (1,039), or had received pre- or postnatal care in the last 12 months (1,140). Women referred to as "pregnant" in this table are to women who were pregnant, or recently pregnant, at the time of the interview. b Includes community, family planning, public health, and other clinics. c Includes other places such as school or college, military facility, home, job site, laboratory, or donation site. d Includes being part of routine or general physical exam, and to start or renew birth control. e Includes being part of a marriage license application, for employment, because potentially exposed to HIV, for immigration or visa application, and for school or college. f Includes women for whom the idea for testing came from a doctor, health department, or hospital or medical policy. g Includes employer or school, government policy, sexual partner, and family or friends.

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--> TABLE J.9 Logistic Regression Model, Predictors of Any Self-Reported HIV Test Among Women by Pregnancy Status, United States, 1995a,b   Odds Ratio Coefficient (95 percent confidence interval)   Model Parameter Not Pregnant Pregnant Not Pregnant Pregnant Intercept -1.2975 -0.4283     Race/ethnicity Black 0.4234* 0.2025 1.53 (1.33–1.76) 1.22 (0.86–1.74) Hispanic 0.0777 -0.1010 1.08 (0.89–1.31) 0.90 (0.61–1.35) Other race -0.1686 -0.0903 0.84 (0.59–1.21) 0.91 (0.50–1.68) White, not Hispanic — —     Marital status Never married -0.0476 0.0857 0.95 (0.82–1.12) 1.09 (0.77–1.55) Formerly married 0.4834* 0.8050* 1.62 (1.42–1.86) 2.24 (1.36–3.68) Married — —     Residence in metro area MSA central 0.3227* 0.2823 1.38 (1.16–1.65) 1.33 (0.88–2.00) MSA other 0.2110* -0.0058 1.23 (1.03–1.47) 0.99 (0.66–1.51) non-MSA — —     Residence-region Northeast -0.2373* 0.1695 0.79 (0.66–0.94) 1.18 (0.80–1.74) Midwest -0.3624* -0.0715 0.70 (0.59–0.82) 0.93 (0.61–1.43) South 0.0078 0.5909* 1.01 (0.86–1.18) 1.81 (1.20–2.71) West — —     Poverty 0–149% 0.1634* 0.0156 1.18 (1.03–1.34) 1.02 (0.75–1.37) 150% or more — —     Years of education Less than 12 years -0.2251* 0.4254* 0.80 (0.67–0.94) 1.53 (1.03–2.26) 12 years -0.2379* 0.1374 0.79 (0.71–0.87) 1.15 (0.86–1.53) 13 years or more — —     Age 15–19 -0.4555* 0.2697 0.63 (0.46–0.88) 1.31 (0.52–3.29) 20–24 0.5249* 0.1734 1.69 (1.37–2.09) 1.19 (0.55–2.55) 25–29 0.6969* 0.1901 2.01 (1.69–2.39) 1.21 (0.56–2.61) 30–34 0.5974* 0.4478 1.82 (1.54–2.14) 1.56 (0.75–3.28) 35–39 0.3486* -0.2564 1.42 (1.21–1.65) 0.77 (0.35–1.70) 40–44 — —    

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-->   Odds Ratio Coefficient (95 percent confidence interval)   Model Parameter Not Pregnant Pregnant Not Pregnant Pregnant HIV risk Moderate/high HIV risk 1.2189* 1.4694* 3.38 (2.77–4.13) 4.34 (2.25–8.41) Low HIV risk — —     NOTE: MSA = metropolitan statistical area. a Both logistic regression models provide a significant fit to the data (p < .00001). For not pregnant women, the model classifies 71 percent of the observed values correctly. For pregnant women, the model classifies 63% of the observed values correctly. Starred coefficients (*) denote statistical significance at p = .05. b A total of 1,472 survey respondents reported that they were either pregnant at the time of the interview (430), had completed a pregnancy with 12 months of the interview (1,039), or had received pre- or postnatal care in the last 12 months (1,140). Women referred to as "pregnant" in this table refer to women who were pregnant, or recently pregnant, at the time of the interview.