Trends in Prenatal Discussion and HIV Testing, 1996–2001: Pregnancy Risk Assessment Monitoring System

Abstract

To assess trends in prenatal discussions about HIV testing and prenatal HIV testing during the period 1996-2001. Using data from the Pregnancy Risk Assessment Monitoring System, a population-based postpartum survey of women, we calculated the self-reported prevalences of discussion of prenatal HIV testing and testing. Data were analyzed using SUDAAN; trends were calculated by logistic regression for states having >/=3 years of data. From 1996 to 2001, significant increases in prenatal discussions about HIV testing were seen in 15 of 17 states. During the period 1996-2001, the prevalence of testing increased significantly in 7 of 8 states. In all states, there was a significant, positive relationship between having a prenatal discussion about testing and having an HIV test (odds ratios ranged from 1.7 to 4.9). We found statistically significant increases in discussions and testing from 1996 through 2001, consistent with guidelines emphasizing routine prenatal testing. Health care providers may have a strong influence on women's decisions to be tested. Because current guidelines call for simplified strategies to reduce barriers to universal prenatal HIV screening, trends in prenatal HIV testing should continue to be monitored to assess the impact of these changes.