Royce RA, et al. IOM workshop presentation, April 1, 1998

Ongoing study

Central North Carolina

Prospective cohort study of 7,000 pregnant women attending public prenatal care clinics

Among the first 88 women interviewed, 86% reported receiving HIV counseling and 71% accepted prenatal HIV testing

Carusi D, Learman LA, Posner SF 1998 Published report

1996

San Francisco

Survey of a convenience sample of 247 antenatal patients at San Francisco General Hospital (English and Spanish speakers) regarding HIV testing policy (routine vs. voluntary testing)

72% accepted HIV tests. Test use was not associated with the presence of risk factors, self-perceived HIV risk, or demographic factors. Test acceptance was associated with patients' knowledge of medical intervention to reduce vertical transmission and their willingness to learn a positive HIV test result. Only 24% knew that perinatal transmission could be reduced with medication. 69% said prenatal HIV testing should be routine and 27% said that it should be done only after specific written consent.

Hospital serves a low-income, publicly insured or uninsured population

Hewitt M 1998 See Appendix J

1995

United States

Analysis of 1995 National Survey of Family Growth. HIV test use assessed among women reporting a pregnancy or receiving pre- or postnatal care within the last 12 months. Test use limited to self-reported testing (excludes mentions of blood donation without mention of HIV test use)

Nearly twice as many women experiencing a recent pregnancy as non-pregnant women reported HIV testing (60% vs. 31%). According to multivariate analyses, pregnant women most likely to be tested are those reporting HIV risk behaviors, formerly married, residents of the South, and those with low educational attainment

Limata C, Schoen E, Cohen D, et al. 1997 Published report

1994, 1995

Northern California Kaiser Permanente Health Plan

Cross-sectional study of HIV test use among pregnant members of Kaiser Permanente Health Plan (31 facilities manage more than 30,000 pregnancies per year). Survey of facilities regarding HIV testing program

HIV test use increased from 50% in 1994 to 63% in 1995. Factors associated with test use in 1994 included ease and accessibility of HIV testing (immediate availability of consent form and test), a designated educator, and presence of a registered nurse on the counseling team

California legislation mandating HIV testing and offering information and counseling went into effect after this study was completed (January 1996). By early 1998, test use had risen to 80% (Schoen EJ, personal communication 1998).

Hewitt M 1998 See Appendix J

1994

United States

Analyses of the 1994 National Health Interview Survey, AIDS Attitude and Knowledge Supplement. HIV test use examined by pregnancy status. Women delivering a baby in the last 13 months identified as "pregnant"

Pregnant women as compared to non-pregnant women were much more likely to report HIV testing (58% vs. 33%)