Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #114630

Amy Beth Levine, MD¹, Keri Monahan, MPH², Rachel John³, Erika Aaron, MSN, CRNP², and Lisa Ulmer, ScD³. (1) Obstetrics and Gynecology, Drexel University College of Medicine, 245 N. 15th Street, Mail stop 495, Philadelphia, PA 19102, (2) Division of HIV/AIDS Medicine, Drexel University College of Medicine, 1427 Vine Street, Mail stop 959, Philadelphia, PA 19102, (3) School of Public Health, Drexel University, 1505 Race Street, MS 660, 11th Floor, Bellet Bldg., Philadelphia, PA 19102, 2672541937, rsj25@drexel.edu

Issues: Recent U.S. Public Health Service guidelines recommend pregnant women be offered a 2nd HIV test in the third trimester under the following conditions: 1) if the woman is determined to be at high risk for HIV, or 2) if the facility has a high rate of seroprevalence of HIV among women of childbearing age.

Description: Little is known about the importance of retesting, barriers to retesting, and strategies for minimizing re-testing barriers. This prospective study includes pregnant women (at least 32 weeks gestation), attending a Philadelphia outpatient OB/GYN clinic, with a documented negative HIV test during the first trimester. Women complete a 10-minute survey of sociodemographic characteristics, health behaviors, and provider practices. Women are then offered an opportunity to be re-tested with the OraQuick Rapid HIV-1 Antibody Test, and acceptance/refusal measured. For women who agree to re-testing, HIV status is recorded. The seroconversion rate is calculated, patient and provider barriers to HIV re-testing investigated using multivariate methods, and options for minimizing barriers analyzed using criteria of significance and feasibility.

Lessons learned: Participants will learn about the seroconversion rate in a sample of high-risk urban pregnant women, major barriers to re-testing, and recommended strategies for minimizing barriers. Results have implications for HIV re-testing policy and improving quality of care for high-risk pregnant women.

Recommendations: Prenatal HIV re-testing programs should consider patient-specific factors leading to acceptance/decline of re-testing for HIV in pregnancy in order to increase access to HIV services and improve quality of care for high-risk pregnant women.

Learning Objectives:

• Participants will learn about the importance of retesting pregnant women for HIV in the third trimester, the major patient and provider barriers to HIV re-testing in the third trimester, and potential strategies for minimizing barriers.

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.