Disparities in prenatal HIV testing: evidence for improving implementation of CDC screening guidelines.
OBJECTIVE
We investigated the within-group and between-group variation in prenatal HIV testing in a sample of low-income pregnant and recently postpartum women.


METHODS
Multivariable linear regression was used to estimate proportional differences in prenatal HIV testing for the total sample and stratified by race.


RESULTS
In bivariate analyses, race and site of care jointly affected the probability of being tested. Hispanic women had the highest probability of being tested in public practice settings but relative to white women, black women had a higher probability of being tested in public and private practice settings. Predictors of prenatal HIV testing differed by race. Receiving prenatal care in a community health center or hospital outpatient clinic increased the probability of testing for Hispanics. Being a recent victim of intimate partner violence was associated with less frequent testing for blacks. Positive beliefs about HIV screening, while significant for blacks and Hispanics, was the only factor associated with testing for whites.


CONCLUSIONS
Our data suggest that racial biases may be influencing providers' approach to testing, rather than CDC's 2001 guidelines for HIV screening of pregnant women. Study findings are being used to modify social marketing campaigns and improve provider trainings regarding prenatal HIV testing.
Pearlman
Deborah N
DN
Brown University, Department of Community Health, Providence, RI 02912, USA. deborah_pearlman@brown.edu
Averbach
Abigail R
AR
Zierler
Sally
S
Cranston
Kevin
K
D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D002487:Centers for Disease Control and Prevention, U.S.; D003376:Counseling / Q000706:statistics & numerical data*; D005260:Female; D015658:HIV Infections / Q000175:diagnosis* / Q000208:ethnology*; D019538:Health Care Surveys; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D008404:Massachusetts; D008875:Middle Aged; D011203:Poverty; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis* / Q000208:ethnology*; D011296:Prenatal Diagnosis / Q000706:statistics & numerical data*; D012923:Social Class; D012959:Socioeconomic Factors; D014481:United States; D044465:White People / Q000706:statistics & numerical data