title: Perinatal HIV counseling and rapid testing in Tijuana, Baja California, Mexico: seroprevalence and correlates of HIV infection.
abstract: OBJECTIVE
  To evaluate the acceptance of counseling and rapid HIV testing and to determine the associated risk factors for HIV infection in pregnant women in Baja California, Mexico.
  
  
  METHODS
  Pregnant women attending Tijuana General Hospital who consented to participate in the study had blood drawn for a rapid HIV test (Determine HIV-1/2; Abbott Diagnostics, North Chicago, IL). A confirmatory enzyme immunoassay and Western blot were performed and demographic and risk factor data were obtained.
  
  
  RESULTS
  From March to November 2003, 1529 (92.5%) of 1653 women who sought prenatal care and 1068 (95.2%) of 1122 women in labor consented to participate. HIV seroprevalence was significantly higher among women screened during labor (12/1068, 1.12%) compared with those seeking prenatal care (5/1529, 0.33%). HIV-infected women were significantly more likely to use injection drugs (12% vs. 1%, P = 0.02), "other" drugs, including methamphetamine, marijuana, and cocaine (65% vs. 6%, P < 0.001), to have more sex partners (3.6 vs. 2.6, P = 0.0002), to not have received prenatal care (41% vs. 13%, P = 0.03), and to have a spouse/partner who used injection drugs (36% vs. 4%, P < 0.001) or "other" drugs (73% vs. 23%, P < 0.001). In multivariate regression analysis, use of methamphetamine (adjusted odds ratio, 17.8, 95% CI, 5.6-56) was independently associated with the risk of HIV infection.
  
  
  CONCLUSIONS
  These findings indicate a wide acceptance of HIV counseling and testing and document a higher HIV seroprevalence among pregnant women delivering at Tijuana General Hospital than current established estimates in Mexico.
authors.affiliation: Department of Pediatrics, University of California San Diego, School of Medicine, La Jolla, CA 92093-0672, USA. rviani@ucsd.edu
authors.forename: Rolando M
authors.initials: RM
authors.lastname: Viani
authors.forename: Maria Rosario G
authors.initials: MR
authors.lastname: Araneta
authors.forename: Jorge
authors.initials: J
authors.lastname: Ruiz-Calderon
authors.forename: Patricia
authors.initials: P
authors.lastname: Hubbard
authors.forename: Graciano
authors.initials: G
authors.lastname: Lopez
authors.forename: Enrique
authors.initials: E
authors.lastname: Chacón-Cruz
authors.forename: Stephen A
authors.initials: SA
authors.lastname: Spector
mesh_terms: D000328:Adult; D003376:Counseling; D003430:Cross-Sectional Studies; D004522:Educational Status; D005260:Female; D015658:HIV Infections / Q000517:prevention & control* / Q000635:transmission; D006801:Humans; D008297:Male; D017533:Marital Status; D008800:Mexico; D011247:Pregnancy; D011295:Prenatal Care; D012309:Risk-Taking; D012731:Sex Counseling; D018454:Spouses; D015819:Substance Abuse, Intravenous / Q000517:prevention & control