title: Named reporting and mandatory partner notification in New York State: the effect on consent for perinatal HIV testing.
abstract: The impact of the implementation of named reporting and mandatory partner notification on the percentage of patients not accepting prenatal human immunodeficiency virus (HIV) testing or deferring prenatal care has been examined in only a preliminary fashion. This retrospective, population-based cohort study of 5,007 patients admitted to a tertiary care labor-and-delivery unit in Central New York State between December 15, 1999, and March 14, 2001, is the first study to address the impact of named reporting and mandatory partner notification on prenatal HIV testing and prenatal care seeking. The percentage of patients who did not undergo prenatal HIV testing was significantly increased after the institution of named reporting and mandatory partner notification: 118/4,030 preimplementation, 59/966 postimplementation, with relative risk (RR) = 2.09 (1.54 < RR < 2.83). This remained significant after logistic regression controlled for confounding variables, with odds ratio (OR) = 1.5 (1.07 < OR < 2.10). The percentage of patients who did not receive prenatal care was significantly increased after the institution of named reporting and mandatory partner notification: 14/4,030 preimplementation, 18/966 postimplementation, with RR = 5.36 (2.68 < RR < 10.75). This remained significant after logistic regression controlled for confounding variables. OR = 3.77 (1.84 < OR < 7.72). There is a strong indication that the institution of named reporting and mandatory partner notification has significantly impacted the willingness of pregnant women to undergo HIV testing and prenatal care. Further analysis of the impact in perinatal populations is needed before the continued implementation of this controversial public policy initiative.
authors.affiliation: Department of Obstetrics and Gynecology, SUNY Upstate Medical University, Syracuse, New York, USA. dolbearg@upstate.edu
authors.forename: Gail L
authors.initials: GL
authors.lastname: Dolbear
authors.forename: Martha
authors.initials: M
authors.lastname: Wojtowycz
authors.forename: Linda T
authors.initials: LT
authors.lastname: Newell
mesh_terms: D015492:AIDS Serodiagnosis / Q000706:statistics & numerical data*; D000328:Adult; D016358:Contact Tracing / Q000331:legislation & jurisprudence*; D018563:Disease Notification / Q000331:legislation & jurisprudence*; D005260:Female; D015658:HIV Infections / Q000175:diagnosis*; D006302:Health Services Research; D006801:Humans; D007258:Informed Consent; D009518:New York; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D018743:Perinatal Care / Q000706:statistics & numerical data*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis*