Article

Maternal and Child Health Journal

, Volume 18, Issue 3, pp 648-656

First online:

Factors Associated with Human Immunodeficiency Virus Screening of Women During Pregnancy, Labor and Delivery, United States, 2005–2006

  • Lauren F. Fitz HarrisAffiliated withICF International, assigned full-time to the Division of HIV/AIDS Prevention, Centers for Disease Control and PreventionAssociation of Schools of Public Health Email author 
  • , Allan W. TaylorAffiliated withEpidemiology Branch, Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention (CDC)
  • , Fan ZhangAffiliated withHealth Services Research and Evaluation Branch, Immunization Services Division, National Center for Immunization and Respiratory Diseases, CDC
  • , Craig B. BorkowfAffiliated withQuantitative Sciences and Data Management Branch, Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, CDC
  • , Bayo C. ArthurAffiliated withHealth Services Research and Evaluation Branch, Immunization Services Division, National Center for Immunization and Respiratory Diseases, CDC
  • , Lisa Jacques-CarrollAffiliated withHealth Services Research and Evaluation Branch, Immunization Services Division, National Center for Immunization and Respiratory Diseases, CDC
  • , Susan A. WangAffiliated withPrevention Branch, Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, CDCGlobal Immunization Division, National Center for Immunization and Respiratory Diseases, CDC
  • , Steven R. NesheimAffiliated withEpidemiology Branch, Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention (CDC)

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Abstract

The purpose of this study was to estimate prenatal human immunodeficiency virus (HIV) screening rates prior to and on admission to labor and delivery (L&D) and to examine factors associated with HIV screening, including hospital policies, with a comparison of HIV and hepatitis B prenatal screening practices and hospital policies. In March 2006, a survey of hospitals (n = 190) and review of paired maternal and infant medical records (n = 4,762) were conducted in 50 US states, DC, and Puerto Rico. Data from the survey and medical record review were analyzed using SAS software v9.2 (SAS Institute, Cary, NC). HIV testing before delivery occurred among 3,438 women (73.9 %); African American and Hispanic women were more likely to be tested than white women [aOR 2.22, 95 % CI (1.6–3.1) and aOR 1.55, 95 % CI (1.1–2.2), respectively]. Among women without previous HIV testing, 138 (16.6 %) were tested after admission to labor and delivery. Policies to test women with undocumented HIV status in at delivery were present in 65 (36.3 %) hospitals. HIV testing after admission to L&D was more likely in hospitals with policies to test women with undocumented HIV status [aOR 5.91, 95 % CI (2.0–17.8)]. Overall, policies and screening practices for HIV were consistently less prevalent than those for hepatitis B. Many women are not being routinely screened for HIV before or at delivery. Women with unknown HIV status were more likely to be tested in L&D in hospitals with testing policies.

Keywords

HIV Perinatal Pregnancy Screening