title: The influence of prevalence and policy on the likelihood that a physician will offer HIV screening in pregnancy.
abstract: 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.
authors.affiliation: Kingston, Frontenac and Lennox & Addington Health Unit, 221 Portsmouth Avenue, Kingston, ON K7M 1V5. koconnor@healthunit.on.ca
authors.forename: Kathleen Steel
authors.initials: KS
authors.lastname: O'Connor
authors.forename: Susan E
authors.initials: SE
authors.lastname: MacDonald
authors.forename: Lisa
authors.initials: L
authors.lastname: Hartling
authors.forename: Rachelle M
authors.initials: RM
authors.lastname: Seguin
authors.forename: Hussein
authors.initials: H
authors.lastname: Hollands
authors.forename: David L
authors.initials: DL
authors.lastname: Mowat
authors.forename: John R
authors.initials: JR
authors.lastname: Hoey
authors.forename: Richard
authors.initials: R
authors.lastname: Massé
authors.forename: Michael L
authors.initials: ML
authors.lastname: Rekart
mesh_terms: 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*