The influence of prevalence and policy on the likelihood that a physician will offer HIV screening in pregnancy.
OBJECTIVE
To determine the extent to which provincial recommendations, reported regional prevalence rates and perceived local prevalence rates of HIV in pregnancy influence a physician's decision to routinely offer prenatal screening for HIV.


METHODS
A random sample of 5,052 family physicians and obstetricians were surveyed by mail. Logistic regression was used to explore the relationships among the variables of interest.


RESULTS
The response rate was 61%. Of these, 69.2% provided prenatal care and were included in the analysis. Physicians were more likely to routinely offer HIV testing if they practiced in provinces with recommendations that supported the universal offer of a test (O.R. = 5.80), independent of living in a region with an estimated prevalence rate exceeding 5/10,000 (O.R. = 1.76), or the perception that the infection rate in their practice justified universal counselling of pregnant women (O.R. = 10.41).


CONCLUSIONS
Provincial recommendations supporting universal HIV testing in pregnancy are reflected in physician practice.
O'Connor
Kathleen Steel
KS
Kingston, Frontenac and Lennox & Addington Health Unit, 221 Portsmouth Avenue, Kingston, ON K7M 1V5. koconnor@healthunit.on.ca
MacDonald
Susan E
SE
Hartling
Lisa
L
Seguin
Rachelle M
RM
Hollands
Hussein
H
Mowat
David L
DL
Hoey
John R
JR
Massé
Richard
R
Rekart
Michael L
ML
D015492:AIDS Serodiagnosis / Q000706:statistics & numerical data*; D002170:Canada / Q000453:epidemiology; D005260:Female; D015528:HIV Seroprevalence; D006291:Health Policy; D006297:Health Services Accessibility; D006302:Health Services Research; D006801:Humans; D016013:Likelihood Functions; D008403:Mass Screening; D010818:Practice Patterns, Physicians'; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis*