Universal prenatal HIV screening: patient attitudes and perceptions

In 1995, Center for Disease Control guidelines were modified to replace targeted HIV screening of pregnant women with universal screening. Public health scholars have argued that one rationale for universal screening is to reduce the potential stigmatization of women of color and lower socioeconomic status who are typically targeted under selective screening. Here, we examine whether experiences and impressions of prenatal screening differ across socioeconomic and racial lines. Data are drawn from an NIH-funded pilot study of 353 pregnant women across several sites in Connecticut, a state with unusually strong prenatal HIV screening laws. We find no significant differences on testing protocols and attitudes toward mandatory HIV screening. However, minority and lower socioeconomic status women are more likely (1) to understand the screening law, (2) to report that their doctor stresses the importance of the test, and (3) to express much higher levels of concern about the confidentiality of the test.