The results of AIDS Clinical Trial 076 indicated that antiretroviral treatment during pregnancy reduced prenatal HIV transmission by 66% and stimulated the recommendation for universal counseling and voluntary testing for all pregnant women. Recent trends indicate an increase in the proportion of pregnant women with HIV diagnosed before giving birth, an increase in HIV positive women offered and accepting treatment during pregnancy, and a reduction in perinatally acquired HIV infections. Education of prenatal providers is crucial to success in furthering the trends towards reduction of perinatally transmitted HIV. These efforts are especially challenging in states where HIV incidence is low and populations are largely rural. This poster will describe current practices in Vermont and New Hampshire and efforts taken to standardize and improve this practice.
A survey was mailed to 119 obstetric practices in Vermont and New Hampshire during 1999; 60 practices responded with information about their counseling and testing practices with pregnant clients. The majority indicated they routinely did HIV counseling and testing with all patients. Nevertheless, only 32% of the practices achieved a 95% or better acceptance rate for testing. In addition, 20% are not documenting counseling and testing when it occurred and over 75% have no written policy on the practice. Barriers to implementation include time constraints, patient rejection, concerns for confidentiality, and lack of standards for conducting counseling. Statewide efforts have been undertaken to build capacity among prenatal care providers in Vermont and New Hampshire to standardize and improve HIV counseling and testing practices with pregnant clients.
Learning Objectives: Participants will be able to: 1.Describe current HIV counseling and testing practices in a bistate region. 2.Identify at least one implication for prenatal outcomes related to HIV transmission as a result of counseling and testing practices. 3.Identify two trategies for educating OB providers about HIV counseling and testing during rpegnancy
Keywords: HIV/AIDS, Prenatal Care
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Dartmouth-Hitchcock Family HIV Program
Vermont Department of Health AIDS Program
New Hampshire STD/HIV Program
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.