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Canadian Journal of Public Health

, Volume 93, Issue 1, pp 31–35 | Cite as

The Influence of Prevalence and Policy on the Likelihood that a Physician will Offer HIV Screening in Pregnancy

  • Kathleen Steel O’ConnorEmail author
  • Susan E. MacDonald
  • Lisa Hartling
  • Rachelle M. Seguin
  • Hussein Hollands
  • David L. Mowat
  • John R. Hoey
  • Richard Massé
  • Michael L. Rekart
Article

Abstract

Objective

To determine the extent to which provincial recommendations, reported regional prevalence rates and perceived local prevalence rates of HIV in pregnancy influence a physician’s decision to routinely offer prenatal screening for HIV.

Design and Methods

A random sample of 5,052 family physicians and obstetricians were surveyed by mail. Logistic regression was used to explore the relationships among the variables of interest.

Results

The response rate was 61%. Of these, 69.2% provided prenatal care and were included in the analysis. Physicians were more likely to routinely offer HIV testing if they practiced in provinces with recommendations that supported the universal offer of a test (O.R.=5.80), independent of living in a region with an estimated prevalence rate exceeding 5/10,000 (O.R.=1.76), or the perception that the infection rate in their practice justified universal counselling of pregnant women (O.R.=10.41).

Conclusions

Provincial recommendations supporting universal HIV testing in pregnancy are reflected in physician practice.

Résumé

Objectif

Nous avons voulu déterminer dans quelle mesure les recommandations provinciales, les taux de prévalence régionaux déclarés et les taux de prévalence locaux perçus du VIH durant la grossesse incitent les médecins à proposer systématiquement un dépistage prénatal du VIH.

Conception et méthode

Nous avons posté un questionnaire à un échantillon aléatoire de 5 052 médecins de famille et obstétriciens et analysé par régression logistique les liens entre les diverses variables.

Résultats

Le taux de réponse a été de 61 %. Nous avons inclus dans l’analyse les 69,2 % de répondants qui dispensaient des soins prénatals. Les médecins avaient plus tendance à proposer systématiquement le test de sérodiagnostic du VIH s’ils exerçaient dans les provinces qui recom-mandent un dépistage universel (rapport de cotes [RC] = 5,80), qu’ils vivent ou non dans une région dont les taux de prévalence estimatifs sont supérieurs à 5 p. 10 000 (RC = 1,76), et qu’ils jugent ou non que le taux d’infection dans leur clientèle justifie de proposer du counselling à toutes les femmes enceintes (RC = 10,41).

Conclusions

Les recommandations provinciales à l’appui du dépistage universel du VIH durant la grossesse se traduisent donc dans les décisions des médecins.

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Copyright information

© The Canadian Public Health Association 2002

Authors and Affiliations

  • Kathleen Steel O’Connor
    • 1
    • 5
    Email author
  • Susan E. MacDonald
    • 2
  • Lisa Hartling
  • Rachelle M. Seguin
    • 2
  • Hussein Hollands
  • David L. Mowat
    • 3
  • John R. Hoey
  • Richard Massé
  • Michael L. Rekart
    • 4
  1. 1.Kingston, Frontenac, and Lennox & Addington Health UnitKingstonCanada
  2. 2.Department of Family MedicineQueen’s UniversityCanada
  3. 3.Population and Public Health Branch, Health Canada, and Department of Community Health and EpidemiologyQueen’s UniversityCanada
  4. 4.University of British Columbia Centre for Disease ControlUniversity of British ColumbiaVancouverCanada
  5. 5.Kingston, Frontenac and Lennox & Addington Health UnitKingstonCanada

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