Objectives. The study estimates rates of prenatal care (PNC) utilization among HIV-infected women enrolled in Medicaid and compares utilization across sociodemographic subgroups.
Methods. NJ Medicaid eligibility files and paid Medicaid claims were matched with NJ AIDS/HIV Registry. PNC use for deliveries occurring 1990-1998 was examined during six months prior to delivery using chi square, logistic regression and GEE.
Results. Among 514 deliveries, 87% utilized any PNC. Use of PNC in NJ increased from 71% in 1991 to 93% in 1996. African Americans and women living in urban areas were less likely to receive PNC, after controlling for other factors. Among those women who received any PNC, 81% were fully observed for 6 months prior to delivery. Among these, 35% received adequate PNC, defined as >5 visits. In multivariate analysis, Hispanics and those in urban areas were less likely to receive adequate number of visits, while women >30 were more likely to receive adequate care. Injection drug users (IDU) and women in urban areas had significantly fewer visits, while women who delivered in 1995 through 1998 had significantly more visits than women who delivered in earlier years.
Conclusions. Despite fairly high overall rates of PNC participation and rates that increased over the study period, the proportion receiving adequate care was fairly low. Women who live in urban areas, minorities and IDUs were less likely to receive care comparable to their counterparts. These results suggest the need to target groups to increase their utilization of PNC and enhance opportunities for prevention of perinatal transmission.
Learning Objectives: At the end of the session, participants will be able to: 1. identify two reasons why prenatal care is especially important for HIV+ women 2. describe the trends of prenatal care utilization in the population studied 3. recognize sociodemographic groups that receive prenatal care at lower rates than their counterparts
Keywords: HIV/AIDS, Prenatal Care
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
Disclosure not received
Relationship: Not Received.