Study Identifies ‘Barriers’ to Prenatal HIV Testing in U.S.

A study published in this month's issue of the American Journal of Public Health found that the "likelihood" of a woman undergoing prenatal HIV testing depends on her medical insurance, her "perception of her physician's recommendations" and hospital location, Reuters Health reports. Dr. Rachel Royce and colleagues from the Research Triangle Institute in North Carolina questioned 1,362 pregnant women at seven hospitals in New York City, Miami, New Haven, Conn., and central North Carolina. Nearly 90% of the women reported having been offered an HIV test during pregnancy and 69.6% of the women reported taking it, but women in New York and Miami were more likely to have undergone testing than those in other locations. Women with private insurance were less likely to undergo testing and women who believed their doctor "did not recommend testing" were less than half as likely to be tested as those who said their doctor indicated a "strong" preference for testing. Reasons for declining the test were "not being at risk" (55.3%), having had a recent test (39.1%) and not being offered a test (11.1%). "This study suggests that the U.S. health care system is falling short of the goal of universal offering of voluntary HIV counseling and testing, and it supports the need to increase HIV testing if HIV infection is to be eliminated among U.S. children," the study states. "[R]outine universal prenatal testing would help reduce the stigma to individuals and to communities, as well as the unavoidable errors of basing test recommendation on individual risk factors or the community prevalence of infection," the study concludes (Reuters Health, 5/1).