Mark H Yudin1, Catherine Moravac, Rajiv R Shah. 1. Department of Obstetrics and Gynecology, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada. yudinm@smh.toronto.on.ca
Abstract
OBJECTIVE: To estimate both human immunodeficiency virus (HIV) testing acceptance rates in pregnancy using an opt-out policy and patient characteristics influencing acceptance. METHODS: At the first prenatal visit, HIV testing was offered using an opt-out approach. Reasons for refusing testing were explored. Demographic information was collected on all study subjects. RESULTS: In the prospective portion of the study, 1,140 of 1,233 women (92.5%) accepted testing. Race was predictive of accepting HIV testing, with Asian women significantly less likely (odds ratio [OR] 0.4; 95% confidence interval [CI] 0.3-0.6; P<.001) and Hispanic women significantly more likely (OR 6.9; 95% CI 2.2-22.0; P=.001) to be tested. Although English as a first language, country of birth, and insurance status were not significantly associated with acceptance, women who were fluent in English were more likely to be tested (OR 2.0; 95% CI 1.2-3.3; P=.01). Our testing rates were significantly higher than the provincial average. CONCLUSION: Using an opt-out strategy, HIV testing rates in our clinic were significantly higher than the provincial average. Rates were influenced by race and fluency in English.
OBJECTIVE: To estimate both human immunodeficiency virus (HIV) testing acceptance rates in pregnancy using an opt-out policy and patient characteristics influencing acceptance. METHODS: At the first prenatal visit, HIV testing was offered using an opt-out approach. Reasons for refusing testing were explored. Demographic information was collected on all study subjects. RESULTS: In the prospective portion of the study, 1,140 of 1,233 women (92.5%) accepted testing. Race was predictive of accepting HIV testing, with Asian women significantly less likely (odds ratio [OR] 0.4; 95% confidence interval [CI] 0.3-0.6; P<.001) and Hispanic women significantly more likely (OR 6.9; 95% CI 2.2-22.0; P=.001) to be tested. Although English as a first language, country of birth, and insurance status were not significantly associated with acceptance, women who were fluent in English were more likely to be tested (OR 2.0; 95% CI 1.2-3.3; P=.01). Our testing rates were significantly higher than the provincial average. CONCLUSION: Using an opt-out strategy, HIV testing rates in our clinic were significantly higher than the provincial average. Rates were influenced by race and fluency in English.
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