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APHA Scientific Session and Event Listing

Laurin J. Kasehagen, MA, PhD¹, Jihong Liu, PhD², and Kenneth D. Rosenberg, MD, MPH¹. (1) Office of Family Health, Oregon Department of Human Services, 800 NE Oregon Street, Suite 805, Portland, OR 97232, 971-673-0383, Laurin.J.Kasehagen@state.or.us, (2) Department of Epidemiology and Biostatistics, University of South Carolina, 800 Sumter St., HESC 208C, Columbia, SC 29208

Background: Human immunodeficiency virus (HIV) testing during pregnancy is a key component of efforts to eliminate perinatal HIV transmission. The US Public Health Service and professional medical associations recommend that health-care providers should include HIV counseling and voluntary testing as part of routine prenatal care for all pregnant women. Methods: We analyzed data from the 2000-01 Oregon Pregnancy Risk Assessment Monitoring System (PRAMS) (n=3509, 72.6% response rate), which asked stratified random samples of recent mothers from birth registry about whether a doctor or midwife suggested getting a blood test for HIV and whether they received one during pregnancy. We excluded 17 mothers without prenatal care. Responses were weighted for oversampling, nonresponse, and noncoverage to be representative of all Oregon live births. Results: Overall, 60.8% of mothers reported a provider suggesting HIV testing and 59.9% reported being tested during pregnancy. Among mothers who were suggested to be tested, 84.9% had HIV tests; among those who did not receive a suggestion, 21.5% received HIV tests. Receiving adequate prenatal care and being minorities were significant predictors of receiving HIV counseling. HIV counseling was the strongest predictor of receiving HIV testing (adjusted OR: 22.8; 95% CI, 19.3-40.1). Having at least 3 pregnancy terminations was the second strongest predictor of receiving HIV testing (AOR: 3.0; 95% CI, 1.3-8.4). Discussion: Providers in Oregon are not providing universal HIV counseling. Opt-in consent has resulted in many women not getting HIV tested during pregnancy. Hopefully, Oregon's new opt-out legislation will result in more women getting tested.

Learning Objectives:

• Learn what proportion of Oregon pregnant women get an HIV test during pregnancy.
• Learn the association between prenatal care provider counseling and women getting an HIV test.
• Learn why opt-out consent programs lead to an increased prevalence of pregnant women getting HIV tested.

Keywords: HIV/AIDS, Prenatal Care

Presenting author's disclosure statement:

Not Answered