Prenatal HIV counseling, testing, and antiretroviral prophylaxis by obstetric and family medicine providers in Alabama.

Nichols SA, Bhatta MP, Lewis J, Vermund SH
Am J Med Sci. 2002 324 (6): 305-9

PMID: 12495296 · DOI:10.1097/00000441-200212000-00003

BACKGROUND - The study reported here assessed the implementation of recommendations for routine universal prenatal counseling and voluntary HIV testing among Alabama physicians who provide prenatal care and determined factors associated with noncompliance.

METHODS - Voluntary, confidential mailed survey of obstetrics and family medicine practitioners.

RESULTS - Of the 138 physicians who responded to a mailed survey in Alabama, 17 (12.3%) indicated that they did not offer universal HIV counseling and testing to pregnant women. Factors associated with failure to offer universal HIV counseling and testing included having more than 50% of patients refuse HIV counseling and testing when offered and never knowingly having given prenatal/perinatal care to women with HIV. Low/medium familiarity with the US Public Health Service recommendations for perinatal zidovudine use to reduce HIV transmission and physician specialty are also suggested as predictors of not offering universal testing.

CONCLUSIONS - Despite the well-established benefits of antiretroviral prophylaxis to prevent vertical transmission of HIV, some physicians in Alabama have been slow to adopt universal testing of their pregnant patients for HIV in the prenatal period. Practitioner education is as important as patient education in eliminating pediatric HIV in the Deep South.

MeSH Terms (20)

AIDS Serodiagnosis Alabama Anti-HIV Agents Directive Counseling Family Practice Female HIV HIV Infections Humans Infectious Disease Transmission, Vertical Patient Acceptance of Health Care Patient Education as Topic Perinatal Care Practice Patterns, Physicians' Pregnancy Pregnancy Complications, Infectious Prenatal Care Preventive Health Services United States Zidovudine

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