Forsyth BW; National HIV Prevention Conference (2003 : Atlanta, Ga.).
Abstr Book 2003 Natl HIV Prev Conf July 27 30 2003 Hyatt Regency Atlanta Hotel Atlanta Ga Natl HIV Prev Conf 2003 Atlanta Ga. 2003; abstract no. M3-B0403.
Yale University School of Medicine, New Haven, CT
BACKGROUND: In the United States, failure to do HIV testing prenatally is now the major barrier to further decreasing perinatal HIV transmission. To address this issue, in 1999 the State of Connecticut implemented a law that included routine offering of HIV testing in pregnancy, offering of testing at delivery if testing had not been done earlier, and, in instances where no testing had been done, the mandatory testing of newborn infants. The effects of this law will be reviewed. METHODS: The presentation will include data from a study (see results below), statewide data, and the results of focus groups. The study included a review of medical records of all women giving birth in two hospitals in Connecticut over three time periods: 9 months prior to the law (Period 1); 3 months post-law (Period 2); and 9 months post-law (Period 3).RESULTS: Prenatal testing rates increased from 22% pre-law, to 87% in Period 2 (P<0.0001) and 94% in Period 3. Changes in testing rates were similar in the two hospitals. The greatest increase in testing was among those receiving prenatal care from private obstetricians (11% pre-law to 88% and 94%, P<0.0001). After the law, "rapid" HIV testing at the time of delivery was only performed on 34% of those who had missed prenatal testing, however, the reason for this was a failure to order the test rather than the refusal of parents. When prenatal testing had been missed, women who were known to have risk factors for HIV (e.g. drug use) were more likely to have a test done at delivery (62% tested), than did those with no identified risk for HIV (27% tested). Results of a statewide survey demonstrated similar increases in prenatal testing rates. Women participating in focus groups spoke positively about testing but expressed concerns about the need to ensure appropriate counseling.CONCLUSIONS: The Connecticut state law has had a dramatic effect on increasing prenatal HIV testing rates. Inclusion of a clause "mandating" testing of newborns has had the effect of changing behavior around prenatal testing and testing at the time of delivery, but has not resulted in enforced testing.
Publication Types:
Keywords:
- Acquired Immunodeficiency Syndrome
- Connecticut
- Counseling
- Female
- HIV Infections
- HIV Seropositivity
- Humans
- Infant
- Infant, Newborn
- Mandatory Testing
- Mass Screening
- Pregnancy
- Prenatal Care
- Research Design
- Risk Factors
- United States
Other ID:
UI: 102261713
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