Some Ob-Gyns Unaware of State Requirements for Recommending HIV Tests, Survey Says

Although almost all ob-gyns recommend HIV testing to all their pregnant patients, some are unclear about state requirements for recommending tests, according to a survey published in the November edition of Obstetrics & Gynecology, Reuters reports. The survey also found that 48% ob-gyns use CDC's recommended opt-out strategy for HIV testing.

In the opt-out approach, which also is recommended by several other organizations, pregnant women are given information about HIV and are told that a test will be performed as part of routine medical testing. The women also are informed that they can decline testing. A second strategy, called opt-in HIV testing, requires that women request the test after being given information about the virus. Women often are required to sign an informed consent form in opt-in approaches.

The survey, conducted by Jay Schulkin and colleagues from the American College of Obstetricians and Gynecologists, found that 52% of the 582 ob-gyns who returned questionnaires said they used the opt-in HIV testing. All but 3% of the respondents reported recommending HIV testing to all of their pregnant patients, even though nearly 75% of ob-gyns considered 5% or fewer of their patients to be at high risk for HIV infection, the survey found.

Fifty-seven percent reported following their state's mandated HIV testing approach, while 43% reported using an approach not consistent with their state's regulation. Nearly one-third of ob-gyns said they did not know if their state required HIV testing during pregnancy. Nearly 74% reported that they provide pretest counseling before HIV testing and about 85% said they provide post-test counseling, the survey found.

"The results of this study suggest that obstetrician-gynecologists may benefit from additional information that could improve their knowledge and practice regarding HIV screening," the investigators wrote. Researchers distributed 1,032 questionnaires for the survey (Reuters, 11/16).

The abstract of the survey is available online.