Abstract
Background
The opioid epidemic and rising rates of injection drug use are increasing the risk of human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV) infections among pregnant people. According to national clinical guidelines, pregnant people should be universally tested for HIV and HBV, and risk-based tested for HCV. The aim of this study was to determine the proportion and characteristics of prenatal HIV, HBV, and HCV testing and diagnosis among pregnant people with Wisconsin Medicaid coverage between 2011 and 2015.
Methods
Wisconsin birth certificates and Medicaid enrollment data were used to identify the sample. Standard billing and diagnosis codes were used to assess study variables. Data for each pregnancy were analyzed to describe the proportion of pregnancies that had evidence of testing, diagnoses, and yearly trends.
Results
Of the 78,917 pregnancies, prenatal testing estimates were 67% for HIV, 73% for HBV, and 6% for HCV. The estimated rate of infections during the study period was 1.82 for HIV, 2.09 for HBV, and 3.52 for HCV per 1000 pregnancies. Compared to the other race/ethnicity groups, pregnant people who were Black were most likely to be tested for HIV (78%) and HBV (80%), and pregnant people who were White were most likely to be tested for HCV (7%).
Conclusions
Clinical testing guidelines have not been effectively translated to practice. Additionally, compared to HIV and HBV, HCV infections during pregnancy are becoming more prevalent, yet current national HCV screening guidelines are the least comprehensive.
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Notes
Pregnant person/people refers to an individual who is pregnant of any gender identity or gender expression.
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Acknowledgements
The first author acknowledges PhD Committee members Susan Zahner, Diane Lauver, Ajay Sethi, Traci Snedden, and James Vergeront for their guidance on this study; and, Alex Dudek, Carly Holmes, Jennifer Orshak, and Morgan White for manuscript review. The first author is a Gwendolyn H. Shapiro Wisconsin Distinguished Fellow. Support for the Gwendolyn H. Shapiro Wisconsin Distinguished Fellowship is provided by the Graduate School, part of the Office of Vice Chancellor for Research and Graduate Education at the University of Wisconsin-Madison, with funding from the School of Nursing, Wisconsin Alumni Research Foundation, and the UW–Madison.
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Watts, T., Stockman, L., Martin, J. et al. Estimates of Prenatal HIV, Hepatitis B Virus, and Hepatitis C Virus Testing Among Pregnant People Enrolled in Wisconsin Medicaid, 2011–2015. Matern Child Health J 24, 177–185 (2020). https://doi.org/10.1007/s10995-019-02841-1
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DOI: https://doi.org/10.1007/s10995-019-02841-1