title: What factors influence obstetrician-gynecologists to follow recommended HIV screening and testing guidelines?
abstract: BACKGROUND
  The purpose of this study was to determine what factors may influence obstetrician-gynecologists' HIV testing practices and to learn more about obstetrician-gynecologists' current HIV screening and testing practices.
  
  
  METHODS
  Survey questionnaires were sent to 1200 American College of Obstetricians and Gynecologists (the College) Fellows and Junior Fellows in practice between October 2009 and January 2010. Four hundred of the recipients were members of the Collaborative Ambulatory Research Network (CARN), and 800 recipients were randomly selected from the ACOG Fellows and Junior Fellows in practice.
  
  
  RESULTS
  The survey response rate was 62.0% (248 of 400) for CARN and 31.1% (249 of 800) for non-CARN. Nearly 100% (99.7%) of the study sample report recommending HIV testing to all pregnant women at least once during each pregnancy, while reported rates for repeat testing in the third trimester remain low (20.1% for all patients and 42.6% for high-risk patients). Two thirds (66.0%) of respondents recommend labor and delivery testing to women with unknown or undocumented HIV status. Fewer than 22.0% of respondents report routinely recommending HIV screening to all non-pregnant women, citing a low-risk population as the most common reason. State laws and regulations have only moderate influence on obstetrician-gynecologists' HIV testing practice, as do practice type, location, and setting.
  
  
  CONCLUSIONS
  The results of this study suggest that the provider's perception about the patients' risk for being infected as well as practice type and location are important factors influencing an obstetrician-gynecologist's decision to screen a nonpregnant woman for HIV.
authors.affiliation: American College of Obstetricians and Gynecologists, Washington, DC 20024, USA. banderson@acog.org
authors.forename: Britta L
authors.initials: BL
authors.lastname: Anderson
authors.forename: Rebecca
authors.initials: R
authors.lastname: Carlson
authors.forename: Jean
authors.initials: J
authors.lastname: Anderson
authors.forename: Debra
authors.initials: D
authors.lastname: Hawks
authors.forename: Jay
authors.initials: J
authors.lastname: Schulkin
mesh_terms: D000328:Adult; D016009:Chi-Square Distribution; D003955:Diagnostic Tests, Routine / Q000706:statistics & numerical data / Q000639:trends; D005260:Female; D019983:Guideline Adherence; D006176:Gynecology / Q000592:standards; D015658:HIV Infections / Q000175:diagnosis*; D006801:Humans; D008403:Mass Screening / Q000592:standards*; D008875:Middle Aged; D009774:Obstetrics / Q000592:standards; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D011247:Pregnancy; D037841:Pregnant People / Q000208:ethnology / Q000523:psychology; D011365:Professional Practice Location / Q000706:statistics & numerical data / Q000639:trends; D011795:Surveys and Questionnaires; D014481:United States; D000078329:Workforce