Prenatal HIV counseling, testing, and antiretroviral prophylaxis by obstetric and family medicine providers in Alabama.
BACKGROUND
The study reported here assessed the implementation of recommendations for routine universal prenatal counseling and voluntary HIV testing among Alabama physicians who provide prenatal care and determined factors associated with noncompliance.


METHODS
Voluntary, confidential mailed survey of obstetrics and family medicine practitioners.


RESULTS
Of the 138 physicians who responded to a mailed survey in Alabama, 17 (12.3%) indicated that they did not offer universal HIV counseling and testing to pregnant women. Factors associated with failure to offer universal HIV counseling and testing included having more than 50% of patients refuse HIV counseling and testing when offered and never knowingly having given prenatal/perinatal care to women with HIV. Low/medium familiarity with the US Public Health Service recommendations for perinatal zidovudine use to reduce HIV transmission and physician specialty are also suggested as predictors of not offering universal testing.


CONCLUSIONS
Despite the well-established benefits of antiretroviral prophylaxis to prevent vertical transmission of HIV, some physicians in Alabama have been slow to adopt universal testing of their pregnant patients for HIV in the prenatal period. Practitioner education is as important as patient education in eliminating pediatric HIV in the Deep South.
Nichols
Stacy A
SA
Department of Epidemiology & International Health, University of Alabama at Birmingham School of Public Health, Birmingham, Alabama 35294-2170, USA.
Bhatta
Madhav P
MP
Lewis
Jennifer
J
Vermund
Sten H
SH
D015492:AIDS Serodiagnosis; D000407:Alabama; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D037001:Directive Counseling; D005194:Family Practice; D005260:Female; D006678:HIV; D015658:HIV Infections / Q000175:diagnosis / Q000188:drug therapy / Q000517:prevention & control* / Q000635:transmission*; D006801:Humans; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D010342:Patient Acceptance of Health Care; D010353:Patient Education as Topic; D018743:Perinatal Care; D010818:Practice Patterns, Physicians'; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy; D011295:Prenatal Care; D011314:Preventive Health Services; D014481:United States; D015215:Zidovudine / Q000627:therapeutic use
D019380:Anti-HIV Agents; D015215:Zidovudine