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

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.