Self-reported experiences of prenatal HIV testing in fresno county

Introduction: Antiretroviral treatment during pregnancy can dramatically reduce the risk of perinatal HIV transmission. In 2008, California AB 682 helped make HIV testing a routine part of prenatal care, an opt-out rather than opt-in practice. This study aimed to assess Fresno County prenatal HIV testing practices, specifically whether women were offered HIV testing during pregnancy, rates of acceptance, and reasons for accepting and declining.

Methods: Between 2008 and 2011, postpartum women awaiting discharge at three Fresno County birthing hospitals were asked to participate in this study. Those who agreed completed a 24-item self-administered questionnaire available in English and Spanish. Demographics, prenatal care and prenatal HIV testing experience were collected. Descriptive statistics and Chi-square analysis were done.

Results: Two hundred forty-three women completed the questionnaire. Mean age was 26.3 years (13 to 45 yrs), 65% were Latina, 46% had less than a high school education, and 47% received prenatal care in a community clinic. Twenty-one women (8.5%) did not know if they received prenatal HIV testing. One hundred seventy women (73%) agreed to testing, of whom 134 received counseling about the test. Thirty-nine women (16%) did not agree to testing, of whom half received counseling. The primary reasons women agreed to prenatal HIV testing were “For the health of the baby” and “My doctor told me I should;” the primary reasons women did not get tested were “I wasn't offered the test” and “I am not at risk.” Accepting prenatal HIV testing was significantly associated with receiving HIV test counseling (Χ2 =14.5, d.f.=1, p <0.001).

Conclusions: The majority of postpartum women surveyed reported receiving prenatal HIV testing and most did so for the health of their baby. Delivery of HIV test counseling by a doctor or nurse may positively influence acceptance of an HIV test during pregnancy.