Patient perceptions of obstetrician-gynecologists' practices related to HIV testing

The objectives of this study were to (1) determine the percentage of obstetrician-gynecologists' patients who have been tested for HIV; (2) examine patient attitudes about HIV testing and patients' knowledge about their own risk status; (3) determine primary reasons patients decline an HIV test; and (4) learn patient recall of how their obstetrician-gynecologists approach the topic of HIV testing.

Survey packets were mailed to each of 687 obstetrician-gynecologists who are members of the Collaborative Ambulatory Research Network (CARN) to distribute to their patients. Data are reported from 851 patient respondents (297 pregnant and 554 non-pregnant), and were analyzed utilizing independent samples t-tests, chi2 analysis, and linear regression.

Two-thirds of respondents (65%/n = 534) reported having been tested for HIV at some point, although the majority (72%) did not recall that their current obstetrician-gynecologist had recommended HIV testing. Among pregnant respondents specifically, 61% did not recall that their current obstetrician-gynecologist had recommended HIV testing, although 82% reported having had an HIV test at some point and 71% stated they had received their most recent HIV test results from their obstetrician-gynecologist during their current pregnancy. Age, race, and pregnancy status were linked to likelihood of patient recall of receiving an HIV testing recommendation from their obstetrician-gynecologist; with young, pregnant, Hispanic, and African-American patients most likely to recall a test recommendation. Perceived low risk was the primary reason given for declining an HIV test. Only 2% of respondents considered themselves high-risk for HIV despite almost half of the sample reporting having had unprotected sex at some point with more than one partner.

Many patients did not recall that their obstetrician-gynecologist had ever recommended HIV testing, although the majority had been tested. Efforts should be made to increase communication between obstetrician-gynecologists and their patients related to HIV risk status and HIV testing.