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Olakunde BO, Pharr JR, Adeyinka DA. HIV testing among pregnant women with prenatal care in the United States: An analysis of the 2011-2017 National Survey of Family Growth. Int J STD AIDS 2020; 31:680-688. [PMID: 32538331 DOI: 10.1177/0956462420921715] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Although there has been significant progress in reducing perinatal human immunodeficiency virus (HIV) transmission, the United States is yet to meet the proposed elimination goal of less than one infection per 100,000 live births. Failure to screen all pregnant women for HIV as recommended by the Centers for Disease Control and Prevention can result in missed opportunities for preventing vertical transmission of HIV with antiretroviral drugs. Using the 2011-2017 National Survey of Family Growth, this study examined HIV testing among pregnant women during prenatal care. We estimated the weighted proportion of self-reported HIV testing among women whose last pregnancy ended within 12 months prior to the interview. Logistic regression models were used to determine the factors associated with HIV testing. Of the 1566 women included in the study, 76.4% (95% confidence intervals [CI] = 72.8-80.0) reported receiving an HIV test during prenatal care. In the multivariable regression model, high school diploma (adjusted odds ratio [aOR] = 1.9, 95% CI = 1.1-3.1), two completed pregnancies (aOR = 1.7, 95% CI = 1.1-2.7), health insurance coverage in the last 12 months (aOR = 1.6, 95% CI = 1.0-2.6), Hispanic race/ethnicity (aOR = 2.8, 95% CI = 1.8-4.4), and non-Hispanic black race/ethnicity (aOR = 2.2, 95% CI = 1.3-3.8) were associated with higher odds of reporting being tested for HIV. However, household income of 300% or more of the federal poverty level (aOR = 0.6, 95% CI = 0.3-0.9) and urban residence (aOR = 0.5, 95% CI = 0.3-0.9) were associated with lower odds of reporting HIV testing. These findings suggest that HIV testing among pregnant women during prenatal care is not universal and may affect achieving the goal of elimination of mother-to-child transmission of HIV in the United States.
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Affiliation(s)
- Babayemi O Olakunde
- Department of Environmental and Occupational Health, School of Public Health, University of Nevada, Las Vegas, NV, USA
| | - Jennifer R Pharr
- Department of Environmental and Occupational Health, School of Public Health, University of Nevada, Las Vegas, NV, USA
| | - Daniel A Adeyinka
- Department of Community Health and Epidemiology, University of Saskatchewan, Saskatoon, Canada
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Cianelli R, Villegas N, Irarrazabal L, Castro J, Ojukwu EN, Adebayo OW, Ferrer L, Montano NP. HIV Testing Among Heterosexual Hispanic Women in South Florida. J Nurs Scholarsh 2019; 51:427-437. [PMID: 30888099 DOI: 10.1111/jnu.12470] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/30/2018] [Indexed: 11/30/2022]
Abstract
PURPOSE The purpose of this study was to examine the influence of selected facilitators, barriers, beliefs, and knowledge suggested by the literature to be associated with human immunodeficiency virus (HIV) testing among heterosexual Hispanic women. DESIGN This study utilizes a cross-sectional design to analyze secondary data from SEPA III: The Effectiveness Trial. SEPA stands for Salud, Educacion, Prevencion y Autocuidado, which translates to Health, Education, Prevention, and Self-Care. The Social Cognitive Model (SCM) guided this study. METHODS Three hundred twenty heterosexual Hispanic women 18 to 50 years of age participated in this study. Data were analyzed using descriptive statistics and logistic regression. FINDINGS The most common facilitators for HIV testing were receiving recommendations from a healthcare provider (HCP) and the test is offered by an HCP rather than women asking for it. The most common barrier to testing was having no reason to believe they were infected. Most women believed a positive test result would encourage them to take better care of themselves. However, as much as 15% of women reported desires to kill or hurt themselves if they test positive. On the other hand, a negative result would make them assume their partners are negative and thus do not need to be tested. Significantly, explanatory variables related to HIV testing were knowledge and the HIV test is offered by an HCP instead of women asking for it. CONCLUSIONS Strengthening HIV knowledge and offering HIV tests are significant contributions that nurses make to the health of Hispanic women. The SCM can be used to design programs to increase HIV testing among Hispanic women. CLINICAL RELEVANCE Nurses are encouraged to offer testing and provide culturally competent HIV prevention education to increase HIV testing among Hispanic women.
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Affiliation(s)
- Rosina Cianelli
- Beta Tau Chapter , Associate Professor of clinical, University of Miami School of Nursing and Health Studies, Coral Gables, FL, USA
| | - Natalia Villegas
- Beta Tau Chapter , Associate Professor, University of Miami School of Nursing and Health Studies, Coral Gables, FL, USA
| | - Lisette Irarrazabal
- Beta Tau Chapter , Assistant Professor, School of Nursing, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - Jose Castro
- Beta Tau Chapter , Infectious Disease Specialist, Professor of Clinical Medicine, University of Miami School of Medicine, Miami, FL, USA
| | - Emmanuela Nneamaka Ojukwu
- Beta Tau Chapter , Doctoral Candidate, University of Miami School of Nursing and Health Studies, Coral Gables, FL, USA
| | | | - Lilian Ferrer
- Alpha Lamba and Beta Tau, Associate Professor, School of Nursing, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - Nilda Peragallo Montano
- Alpha Alpha, Dean and Professor, University of North Carolina School of Nursing, Chapel Hill, NC, USA
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Taveras J, Trepka MJ, Madhivanan P, Gollub EL, Dévieux JG, Ibrahimou B. HIV risk and testing behaviors among pregnant women tested for HIV in Florida by site type, 2012. Women Health 2019; 59:815-827. [PMID: 30714499 DOI: 10.1080/03630242.2019.1565902] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The numbers of perinatal human immunodeficiency virus (HIV) infections in the United States have continued to decline, but the prevalence of female adults and adolescents living with diagnosed HIV infection continues to rise. Opportunities still exist to prevent mother-to child HIV transmission. The objective of this study was to identify demographics, HIV risk, and testing behaviors among pregnant women and to compare these characteristics by HIV testing site type. Multivariable analyses were conducted to examine demographics, HIV risk, and testing behaviors among 24,836 records of pregnant women publicly tested for HIV in the state of Florida in 2012. The testing records indicated that Latina and non-Hispanic black (NHB) women had decreased odds of reporting partner risk compared to those from non-Hispanic white women (Latina: adjusted odds ratio [AOR] 0.20, 95 percent confidence interval [CI]: 0.14-0.28; and NHB AOR 0.14, 95 percent CI: 0.10-0.21), and women tested in prisons/jails had higher odds of reporting previous HIV testing compared to those tested in prenatal care sites (AOR 1.86, 95 percent CI: 1.03-3.39). An understanding of HIV risk and testing behaviors among pregnant women by site type may enhance current targeted testing and prevention strategies for pregnant women and facilitate timely linkage to care.
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Affiliation(s)
- Janelle Taveras
- a HIV Prevention Program, Florida Department of Health in Broward County , Fort Lauderdale , Florida , USA.,b Department of Epidemiology , Robert Stempel College of Public Health and Social Work, Florida International University , Miami , Florida , USA
| | - Mary Jo Trepka
- b Department of Epidemiology , Robert Stempel College of Public Health and Social Work, Florida International University , Miami , Florida , USA
| | - Purnima Madhivanan
- b Department of Epidemiology , Robert Stempel College of Public Health and Social Work, Florida International University , Miami , Florida , USA
| | - Erica L Gollub
- c Department of Health Studies , College of Health Professions, Pace University , Pleasantville , New York , USA
| | - Jessy G Dévieux
- d Department of Health Promotion and Disease Prevention , Robert Stempel College of Public Health and Social Work, Florida International University , Miami , Florida , USA
| | - Boubakari Ibrahimou
- e Department of Biostatistics , Robert Stempel College of Public Health and Social Work, Florida International University , Miami , Florida , USA
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Koumans EH, Harrison A, House LD, Burley K, Ruffo N, Smith R, FitzHarris L, Johnson CH, Taylor AW, Nesheim SR. Characteristics associated with lack of HIV testing during pregnancy and delivery in 36 U.S. states, 2004-2013. Int J STD AIDS 2018; 29:1225-1233. [PMID: 29969977 PMCID: PMC6698709 DOI: 10.1177/0956462418780053] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The Centers for Disease Control and Prevention and the American Congress of Obstetricians and Gynecologists recommend universal prenatal HIV testing to prevent perinatal HIV transmission in the U.S.; since the 1990s perinatal HIV transmission has declined. In 2006, 74% of women with a recent live birth reported testing for HIV prenatally or at delivery. We used Pregnancy Risk Assessment Monitoring System data from 36 states and New York City from 2004 to 2013 (N = 387,424) to assess characteristics associated with lack of self-reported testing and state-to-state variability in these associations. Overall, 75.2% (95% confidence interval [CI] 75.0-75.5) of women with a recent live birth reported an HIV test. There were significant differences in testing prevalence by state, ranging from 91.8% (95% CI 91.0-92.6) in New York to 42.3% (95% CI 41.7-43.5) in Utah. In adjusted analysis, characteristics associated with no reported testing included being married, white, non-Hispanic, multiparous, not smoking during pregnancy, and having neither Medicaid nor Special Supplemental Nutritional Program for Women, Infants, and Children. White married women were 57% (adjusted prevalence ratio [aPR] 1.57, 95% CI 1.52-1.63) more likely to report no test compared to white unmarried women. Multiparous married women were 57% (aPR 1.57, 95% CI 1.51-1.64) more likely to report no test compared to multiparous unmarried women. Women who were married, white, non-Hispanic, and multiparous women were 23% less likely to be tested than other women combined. Marital status was significantly associated with lower prevalence of testing in 35 of the 37 reporting areas, and race was significant in 30 of 35 states with race information. The prevalence of reported HIV testing during pregnancy or at delivery remains below 80%. Opportunities exist to increase HIV testing among pregnant women, particularly among certain subpopulations.
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Affiliation(s)
- Emilia H Koumans
- Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Ayanna Harrison
- Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
- DB Consulting Group, Inc., Atlanta, GA, USA
| | - L Duane House
- Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Kim Burley
- Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
- DB Consulting Group, Inc., Atlanta, GA, USA
| | - Nan Ruffo
- Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
- DB Consulting Group, Inc., Atlanta, GA, USA
| | - Ruben Smith
- Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Lauren FitzHarris
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
- ICF, Atlanta, GA, USA
| | - Christopher H Johnson
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Allan W Taylor
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Steven R Nesheim
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Namara-Lugolobi EC, Nakigozi G, Namukwaya Z, Kaye DK, Nakku-Joloba E. Prevalence and predictors of unknown HIV status among women delivering in Mulago National Referral Hospital, Kampala, Uganda. Afr Health Sci 2017; 17:963-973. [PMID: 29937866 PMCID: PMC5870289 DOI: 10.4314/ahs.v17i4.3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Knowledge of a person's HIV status during pregnancy is critical for prevention of mother to child transmission of HIV. OBJECTIVES To determine the prevalence and factors associated with unknown HIV status among women delivering in Mulago Hospital. METHODS This was a cross-sectional study of women that had just delivered. The women's demographic characteristics, health seeking behaviour, health system-related factors and knowledge on PMTCT were collected. Fisher's exact test, Wilcoxon rank sum test and logistic regression were used to test associations. RESULTS The prevalence of unknown HIV status was 2.6% (10/382). Attending ANC at higher level facilities (OR =0.1 95% CI 0.0 - 0.4) and having been counselled for HIV testing during ANC (OR=0.1, 95% CI 0.0 - 0.4) were associated with likelihood of having a known HIV status. Out of the ten women with unknown HIV status, 4/6 who attended ANC in public/government accredited health facilities "opted out" of HIV testing due to personal reasons. Among the four who attended ANC in private clinics, two were not offered HIV testing and one "opted out". CONCLUSION Most participants had a known HIV status at labour (97%). Private clinics need to be supported to provide free quality HCT services in ANC.
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Affiliation(s)
- Emily C Namara-Lugolobi
- Makerere University - Johns Hopkins University (MU-JHU) Research Collaboration, Kampala, Uganda
| | - Gertrude Nakigozi
- Makerere University College of Health Sciences, School of Public Health, Kampala, Uganda
| | - Zikulah Namukwaya
- Makerere University - Johns Hopkins University (MU-JHU) Research Collaboration, Kampala, Uganda
| | - Dan K Kaye
- Makerere University College of Health Sciences, Department of Obstetrics and Gynecology, Kampala, Uganda
| | - Edith Nakku-Joloba
- Makerere University College of Health Sciences, School of Public Health, Kampala, Uganda
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Mwembo-Tambwe ANK, Kalenga MK, Donnen P, Humblet P, Chenge M, Dramaix M, Buekens P. [HIV testing among women in delivery rooms in Lubumbashi, Democratic Republic of the Congo: a catch-up strategy for prevention of mother-to-child transmission]. Rev Epidemiol Sante Publique 2013; 61:21-7. [PMID: 23337841 DOI: 10.1016/j.respe.2012.05.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2011] [Revised: 04/24/2012] [Accepted: 05/07/2012] [Indexed: 10/27/2022] Open
Abstract
BACKGROUND Although HIV testing is offered during antenatal care, the proportion of women giving birth without knowing their HIV status is still important in DR Congo. The objective of this study was to determine the acceptability of rapid HIV testing among parturients in labor room, and to identify factors that are associated with the acceptability of HIV testing. METHODS Intervention including rapid HIV testing among pregnant women in labor rooms in Lubumbashi for 5 months, from September 2010 to February 2011. Pregnant women who tested HIV positive were attended by prevention of mother-to-child transmission service. Descriptive statistical analysis and logistic regression were performed. RESULTS Among 474 pregnant women who enter the labor room, 433 (91.4%; confidence interval [CI]: 95%: 88.4-93.7%) had voluntary testing for HIV in the labor room after counseling. The acceptance of rapid testing for HIV was significantly higher when the duration of counseling was less or equal to 5 minutes (adjusted Odds ratio [aOR]=5.8; [CI] 95%: 2.6-13); among those who did not report having this screening test during antenatal care (aOR=3.8; [CI] 95%: 2-7.8), among those who were in early labor (aOR=2.3; [CI] 95%: 1.2-4.7) and lower in adolescents than in adults (aOR=0.1; [CI] 95%: 0.0-0.7). CONCLUSION Counseling and voluntary HIV testing are accepted in our labor rooms. Consistently offering this service in the labor room could be a catch-up strategy to be combined with antenatal care testing.
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Affiliation(s)
- A N K Mwembo-Tambwe
- Département de gynécologie et obstétrique, faculté de médecine, université de Lubumbashi, Lubumbashi, République démocratique du Congo.
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