HIV Testing Behaviors Among Pregnant Women in North Carolina: A Cross-Sectional Study Using 2008 PRAMS Participants

Objective: To examine the association between pregnancy intendedness and HIV testing among pregnant women in North Carolina using data from the 2008 Pregnancy Risk Assessment Monitoring System (PRAMS). Methods: Since PRAMS utilizes a complex weighted design, SAS 9.2 statistical software and SAS callable SUDAAN were used to account for the complex PRAMS sampling design and to calculate the adjusted and unadjusted odds ratios at 95% confidence intervals (CIs). Logistic regression analysis was conducted to determine HIV testing behaviors among pregnant women in North Carolina. Univariate analysis provided frequency distributions of the variables. Bivariate and multivariate analyses were used to assess the relationship between pregnancy intendedness and HIV testing and the covariates. Statistical significance was set at p<.05 for all analyses. Results: Pregnancy intendedness was strongly associated with HIV testing among pregnant women. Women with no pregnancy intentions had significantly decreased odds of HIV testing (OR 0.52, CI: 0.34-0.78). After adjustment for covariates in the multivariate analysis, results showed significantly decreased odds of HIV testing among unmarried women and participants with no health insurance (OR 0.43, CI: 0.23-0.80; OR 0.49, CI: 0.27-0.89, respectively). Discussion: Policies are needed to increase HIV testing for these groups of women and for providers to comply with the CDC recommendations for testing all pregnant women. Further studies are needed to evaluate interventions to increase HIV testing rates among pregnant women.