Increased HIV Testing with an On-Site Prenatal Clinic Counselor

Abstract

This report evaluates rates of confidential HIV testing in an inner-city prenatal clinic after the establishment of a specially-trained HIV counselor whose role supplemented the provision of prenatal care. Acceptance rates for testing were also evaluated by patient age and HIV risk category. In an inner-city university-based prenatal clinic, 1,329 women registered for prenatal care; all had a formal one-on-one education session with the counselor at their registration visit, after which confidential HIV testing was offered. The six-month period in the clinic prior to the counselor's placement was used for comparison in terms of proportion of patients who were HIV tested; over that time, 614 women registered for obstetric care. 64% of patients underwent HIV testing after counseling, compared to a 14% testing rate among registrants in the clinic prior to the counselor's placement (P< 0.001 by chi square). HIV testing was accepted at highest rates among substance abusers (89%), and women over 20 years of age (90-100%). Restriction of testing to women in HIV risk groups alone would have failed to detect 3 of 9 seropositive patients. Confidential HIV testing was well accepted in an on-site prenatal clinic center. Uniformity of counseling, combined with the routine offering of testing to all women regardless of real or perceived HIV risks, may have helped contribute to a five-fold increase in patient testing rates over a system in which consistent counseling could not be guaranteed. HIV testing by risk groups alone would have missed one-third of seropositive women.

Key Words:

• Human immunodeficiency virus (HIV)
• Prenatal testing
• Pregnancy complications
• Infection