title: Women who decline antenatal screening for HIV infection in the era of universal testing: results of an audit of uptake in three London hospitals.
abstract: Universal screening for HIV in early pregnancy is strongly promoted policy in the United Kingdom with a target of 90 per cent uptake. We identified characteristics of women declining screening by conducting an audit at three hospitals in inner north London. In early 2002 midwives were asked to complete an audit form following first antenatal appointment. Of 2,710 women attending 401 (15 per cent) declined an HIV test. Of women who declined 38 per cent reported they had been tested for HIV in the past; 65 per cent accepted every other antenatal test. In multivariable analysis parity (OR: 1.19; 95 per cent CI 1.10-1.29 per additional child), declining other tests (OR: 3.10; 95 per cent CI 2.44-3.93 per test declined) and previous HIV testing (OR: 1.70; 95 per cent CI 1.30-2.23) were predictors of declining an HIV test. Women declining screening were not obviously from high-risk demographic groups: women from sub-Saharan Africa were not at greater risk of declining an HIV test than women from other regions.
authors.affiliation: Department of Primary Care and Population Science, University College London and Camden and Islington Health Authority, London, UK. s.conaty@pcps.ucl.ac.uk
authors.forename: S J
authors.initials: SJ
authors.lastname: Conaty
authors.forename: J A
authors.initials: JA
authors.lastname: Cassell
authors.forename: U
authors.initials: U
authors.lastname: Harrisson
authors.forename: P
authors.initials: P
authors.lastname: Whyte
authors.forename: L
authors.initials: L
authors.lastname: Sherr
authors.forename: Z
authors.initials: Z
authors.lastname: Fox
mesh_terms: D000328:Adult; D003955:Diagnostic Tests, Routine / Q000706:statistics & numerical data*; D005260:Female; D015658:HIV Infections / Q000175:diagnosis*; D019538:Health Care Surveys; D006801:Humans; D016015:Logistic Models; D008131:London; D008875:Middle Aged; D008913:Minority Groups / Q000523:psychology / Q000706:statistics & numerical data; D010342:Patient Acceptance of Health Care / Q000208:ethnology / Q000706:statistics & numerical data*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis*; D011296:Prenatal Diagnosis / Q000706:statistics & numerical data*; D012067:Religion; D012307:Risk Factors