The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #53981

Sohini Sengupta, PhD, MPH, Department of Social Medicine, The University of North Carolina at Chapel Hill, Wing D Medical School, CB#7164, Chapel Hill, NC 27599-7164, 919 843-6881, sengups@med.unc.edu and Bernard Lo, MD, Program in Medical Ethics, University of California, San Francisco, 521 Parnassus Ave., Room C-126, Box 0903, San Francisco, CA 94143-0903.

BACKGROUND: A new U.S. policy on prenatal HIV testing recommends routine HIV testing in which all pregnant women will be screened for HIV with no requirement of separate, written informed consent, and pretest counseling. Women would have the right to refuse the HIV test. Because this is a departure from opt-in testing guidelines, we studied pregnant women's perceptions of this new policy. METHODS: Seventy-three in-person interviews were completed with Black and Hispanic pregnant women from four prenatal clinics in San Francisco, Chapel Hill, NC, and Washington, D.C. A qualitative interview guide explored pregnant women's experiences with prenatal HIV testing, and their perceptions regarding the new policy. One-hour interviews were audiotaped, and interview transcripts were read for content analysis, and to identify/code themes. RESULTS: Qualitative findings suggested that 93% had been tested for HIV while pregnant, but only 55% were offered the test and 47% were given pretest counseling (15.1% were given information about the importance of HIV testing during pregnancy). When asked about the new policy, 63% liked it overall, but 49.3% said pregnant women need to be explicitly told that HIV testing is part of routine prenatal care. Furthermore, 66% were concerned that it lacked pretest counseling, particularly for less educated or non English-speaking women. CONCLUSIONS: We found that pregnant women of color were supportive of routine HIV testing, but to make this new policy more acceptable, local clinics would need to be explicit that HIV testing is part of prenatal care, and offer some type of pretest counseling.

Learning Objectives:

• Recognize the experiences pregnant women have had with HIV testing in four different prenatal clinics in the U.S.
• Identify specific aspects of the new policy on routine HIV testing in prenatal care settings.
• Identify the perceived benefits and concerns pregnant women have with respect to the new policy on HIV testing in prenatal care settings.

Keywords: HIV/AIDS, Pregnancy

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.