241181 Disparities in Prenatal HIV Test Counseling: Findings from the 2007 Los Angeles Mommy and Baby (LAMB) Project

Tuesday, November 1, 2011

Shin Margaret Chao, PhD, MPH , Maternal, Child, & Adolescent Health, Los Angeles County-Department of Health Services, Los Angeles, CA
Chandra Higgins, MPH , Mcah, Los Angeles County, Los Angeles, CA
Nirvi Shah, MPH , Maternal Child & Adolescent Health, Los Angeles County, Palos Verdes Pensinsula, CA
Jessica Chow, MPH , Department of Epidemiology, UCLA School of Public Health, Los Angeles, CA
Michael C. Lu, MD, MPH , Department of Community Health Sciences, University of California Los Angeles School of Public Health, Los Angeles, CA
Fathima Wakeel, PhD, MPH , UCLA Center for Healthier Children, Families and Communities, Los Angeles, CA
Luwam Semere, MD , Robert Wood Johnson Foundation Clinical Scholars Program, Department of Medicine and Obstetrics and Gynecology, University of California Los Angeles School of Medicine, Los Angeles, CA
Erin Saleeby, MD, MPH , Robert Wood Johnson Foundation Clinical Scholars Program, Department of Medicine and Obstetrics and Gynecology, University of California Los Angeles School of Medicine, Los Angeles, CA
Cynthia Harding, MPH , Maternal, Child, and Adolescent Health, Los Angeles County Department of Health Services, Los Angeles, CA
Background To reduce perinatal HIV transmission, the U.S. Preventive Services Task Force and medical professional organizations recommend universal HIV counseling and voluntary testing as part of routine prenatal care. Methods To evaluate HIV counseling in Los Angeles County (LAC), we analyzed data from the 2007 LAMB survey (n=6,264), which asked new mothers whether their doctor or health care workers discussed getting tested for HIV during prenatal care visit. LAMB is a population-based mail survey of LAC residents who recently gave birth to a live-born infant. All calculations were performed using data weighted to 2007 LAC population data. Results: Overall, 73% of mothers received HIV test counseling. High proportions of African American and Latino mothers received counseling (79% and 76%, respectively), followed by Asian/Pacific Islanders (66.2%) and whites (63.5%). Racial disparities remained after controlling for maternal age, education level, and family income. African American mothers were 1.7 times more likely to receive HIV counseling than whites (aOR=1.7, 95% CI=1.3, 2.1); Latinas were 1.5 times more likely to receive HIV counseling than whites (aOR=1.5, 95% CI=1.1,1.6). An annual family income less than $40,000 was also a predictor of receiving HIV counseling (aOR=2.0, 95% CI=1.4, 2.1). However, having adequate prenatal care and insurance type (Medi-Cal) were not. Discussions: Prenatal providers in LAC aren't providing universal HIV counseling. Our data emphasizes the need to improve prenatal HIV test counseling services among all women regardless of maternal characteristics. LAMB data can be used to monitor prenatal care counseling on HIV prevention in LAC.

Learning Areas:
Administer health education strategies, interventions and programs
Epidemiology
Public health or related education
Public health or related laws, regulations, standards, or guidelines

Learning Objectives:
Identify the proportion of women getting prenatal HIV counseling in LA County. Learn disparities in prenatal HIV counseling in LA County. Identify the maternal populations are less likely receive prenatal HIV counseling during pregnancy.

Keywords: Maternal and Child Health, Outcomes Research

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to present because I oversee LAMB project
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.