Training of obstetric nurses and HIV testing in pregnancy at a managed care organization

The purpose of this study was to evaluate the effectiveness of an HIV Training Programme for obstetric nurses at a managed care organization. Nurses were trained to counsel pregnant women about the HIV antibody test according to the latest recommendations made by the US Public Health Service and the Texas legislature. Training improved the nurses' overall knowledge about the content of the programme and nurses were more likely to offer the HIV test to all pregnant women. Still, contrary to what was predicted, the nurses did not give more information to increase the knowledge pregnant women had about HIV infection, transmission and available treatments. However, pregnant women who received prenatal care after the nurses attended the programme were more likely to be tested than women who received prenatal care before the nurses were trained (96% versus 48%); in turn, the likelihood that high-risk women would be tested for HIV also increased (94% versus 60%). There was no evidence that mandatory testing with right of refusal would deter pregnant women from being tested for HIV. The increased rate of HIV testing was attributable to the providers asking their patients to be tested rather than on their patients' knowledge of its benefits.