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Examining the effectiveness of an opt-in approach to prenatal human immunodeficiency virus screening
Christopher V Almario1, Eric J Moskowitz, Jeanette Koran
1Department of Obstetrics and Gynecology, Jefferson Medical College of Thomas Jefferson University, Philadelphia, PA, USA.
Objective:
We sought to determine the prenatal human immunodeficiency virus (HIV) screening rate when using an opt-in policy and to find variables predictive of screening.
Study Design:
This was a case-control study examining gravid women with a prenatal visit and a delivery at our hospital in 2005. Cases were defined as women who did not undergo HIV screening during the first or second prenatal visit. Our institution used an opt-in approach to HIV screening.
Results:
Overall, 71% (291/412) of women underwent HIV screening at the first or second prenatal visit. Patient refusal was the most common reason for not being screened (15%; 62/412). Women who were < or = 25 years old, were unmarried, and received care from maternal-fetal medicine attendings or family practitioners were more likely to undergo HIV screening.
Conclusion:
With an opt-in approach, 29% of women were not screened for HIV during their early prenatal care. An opt-in policy also leads to screening rates that are provider dependent.