Who and why? HIV-testing refusal during pregnancy: implication for pediatric HIV epidemic disparity

To identify characteristics of pregnant women who refuse HIV testing and determine predictive factors and the reasons for refusal, we conducted face-to-face interviews of pregnant women at prenatal clinics of public and private hospitals. We found 8% (n=65) of 826 pregnant women interviewed refused HIV testing. In bivariate analysis, foreign-born pregnant women residing in Los Angeles County were twice more likely to refuse HIV testing than U.S.-born pregnant women (odds ratio [OR] = 1.97, 95% confidence interval [CI] 1.11-3.49, p <.05). In a multivariate stepwise logistic regression model analysis, variables that were independent predictors of HIV testing refusal during pregnancy were being foreign-born (OR = 2.11, 95% CI 1.07-4.38), not receiving general information about HIV (OR = 7.48, 95% CI 1.86-30.01), and not receiving specific information about HIV and pregnancy (OR = 3.54, 95% CI 1.91-6.57). The most common reasons for testing refusal were being in a monogamous relationship for foreign-born women (41%) and already being tested for U.S.-born women (65%).