title: HIV voluntary counseling and testing at an abortion clinic: missed opportunities for diagnosis.
abstract: BACKGROUND
  Most abortion clinics in the US do not provide opt-out HIV testing, and thus women electing abortion may not receive adequate screening for HIV. We sought to determine whether the standard practice of offering voluntary HIV counseling and testing (VCT) services to women electing abortion results in detection of undiagnosed HIV infection.
  
  
  METHODS
  Two thousand twenty-five women electing abortion were consecutively offered VCT at a public hospital-based, urban abortion clinic. Unlinked, anonymous HIV surveillance testing was conducted subsequent to voluntary testing without patients knowing of the surveillance study testing at the time. Multivariable analysis was used to determine factors associated with opting for VCT.
  
  
  RESULTS
  Of the 13 women (0.6%) who tested positive for HIV, 8 had been previously diagnosed. Of the 5 women without previous diagnosis, only 1 opted for VCT. Overall, 530 (26%) women opted for VCT. Factors associated with opting for VCT in multivariable analysis (odds ratio, 95% confidence interval) were sex with an injection drug user (1.9, 1.1-3.2), presenting in the second trimester (1.3, 1.0-1.6), economic hardship (1.3, 1.0-1.5), partner difficulties (1.8, 1.3-2.4) and having public health insurance (1.6, 1.2-2.3).
  
  
  CONCLUSIONS
  HIV testing via VCT did not effectively diagnose previously undiagnosed HIV infections among women seeking abortion in this clinical setting.
authors: Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, CA 94143, USA. newmanns@obgyn.ucsf.edu
authors: Sara J
authors: SJ
authors: Newmann
authors: Mi-Suk Kang
authors: MS
authors: Dufour
authors: Willi
authors: W
authors: McFarland
authors: Laetitia
authors: L
authors: Oderman
authors: Timothy
authors: T
authors: Kellogg
authors: Brian
authors: B
authors: Louie
authors: Eleanor A
authors: EA
authors: Drey
mesh_terms: D000028:Abortion, Induced; D000328:Adult; D003376:Counseling; D003430:Cross-Sectional Studies; D005260:Female; D006679:HIV Seropositivity / Q000097:blood / Q000453:epidemiology*; D006773:Hospitals, Municipal; D006801:Humans; D008403:Mass Screening; D010044:Outpatient Clinics, Hospital; D010342:Patient Acceptance of Health Care; D010353:Patient Education as Topic; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000097:blood / Q000453:epidemiology*; D011262:Pregnancy Trimester, Second; D012495:San Francisco / Q000453:epidemiology; D018571:Sentinel Surveillance; D047568:Unsafe Sex; D035141:Voluntary Programs; D055815:Young Adult