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Abstract
An important step in preventing mother-to-child transmission is testing pregnant women for HIV. Health literacy measures, such as HIV knowledge and risk perception, may determine which women are tested in prenatal clinics where routine opt-out testing is not available. A survey was conducted in Guayaquil, Ecuador in 2006 (n=485), where approximately 0.7% of HIV tests in prenatal clinics were positive. Pregnant women over the age of 18 were invited to complete the survey in the waiting rooms at four city hospitals. There were 67.2% of women reported being tested previously for HIV. The most notable finding was that women who perceived a risk were 1.74 times more likely to request testing (p=0.021), but a woman's risk perception was not related to established risk factors. In addition, a physician's recommendation would result in the testing of nearly all women (94.3%). This data suggest that interventions in prenatal care clinics should incorporate educational strategies to increase accurate perception of personal risk. These efforts must occur in conjunction with increasing the access to HIV tests to achieve the goal of universal prenatal testing.
Acknowledgements
The New York Academy of Medicine and the Arnold P. Gold Foundation provided funding for this project. The authors would also like to acknowledge the contributions of Marlene Lino, Mariana Bustamante and Melida Riofrio who assisted with data collection and Dr Stephen Schensul, University of Connecticut who provided statistical consultation. Support for the project was also provided by the following physicians from the four hospitals where the study was conducted: Dr Rita Vera, Dr Zenovia Vargas, Dr Rebeca Yoncee and Dr Mercedes Ortiz. This project was made possible with the help of these individuals.