Human immunodeficiency virus infection and women: a survey of missed opportunities for testing and diagnosis.
OBJECTIVE
Our purpose was to describe factors that prompted testing of women infected with the human immunodeficiency virus and health encounters in which missed opportunities for diagnosis occurred.


METHODS
An observational investigation of 81 human immunodeficiency virus-infected women in the Chicago area was performed by means of an interviewer-administered survey. Patient demographic data, health history, and health care contacts were elicited.


RESULTS
Sixty-five women (80%) had at least one documented missed opportunity during the 12 months before their diagnosis. Seventy-eight percent of those women with missed opportunities had them occur at reproductive health encounters. Of 25 pregnant women pregnant in the year before their eventual diagnosis, 12 failed to be diagnosed during that pregnancy.


CONCLUSIONS
Despite visits to reproductive health care providers, the presence of symptoms suspicious for human immunodeficiency virus disease, high-risk behaviors, and even specific requests for testing by many of the women, numerous opportunities for the earlier diagnosis of human immunodeficiency virus infection were missed.
MacDonald
S R
SR
Department of Obstetrics and Gynecology, Northwestern University Medical School Northwestern Memorial Hospital, Chicago, Illinois, USA.
Skor
A
A
Socol
M L
ML
Garcia
P M
PM
D000163:Acquired Immunodeficiency Syndrome / Q000175:diagnosis*; D000328:Adult; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D003625:Data Collection; D003695:Delivery of Health Care; D005260:Female; D006282:Health Personnel; D006801:Humans; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D011247:Pregnancy; D012098:Reproduction; D013997:Time Factors