Many Doctors Don't Offer HIV Test to All in Pregnancy

A survey of Ohio doctors found that less than half offered HIV tests to pregnant women as part of routine screening, and about a third said they offer the test to 25 percent or fewer of their pregnant patients. Treating HIV-infected pregnant women with antiretroviral drugs can dramatically reduce the chances that the baby will get HIV before, during or after birth.

Dr. Joan Duggan and colleagues from the Medical College of Ohio-Toledo surveyed 431 physicians in obstetrics/gynecology and primary care regarding their HIV screening practices. The results are based largely on the responses of 261 physicians who routinely saw pregnant women. Less than half (42 percent) of physicians offered HIV testing as part of the standard prenatal battery of tests in their practice, while 36 percent of physicians offered testing to less than a quarter of their pregnant patients and/or tested only those pregnant women with a risk factor for HIV infection.

Obstetricians did better than family physicians: More than 90 percent routinely offered HIV tests to patients. Fifty-four percent of respondents felt HIV testing during pregnancy should be a routine part of care, but 7 percent of doctors felt it was not necessary for most pregnant women. Only 41 percent of physicians included all the elements of HIV pretest counseling required by Ohio state law.

The US Public Health Service currently recommends HIV counseling and voluntary testing for all women during pregnancy. Typically, 44 percent to 80 percent of pregnant women who are offered the test agree to it, according to the study. The full report, "Survey of Physician Attitudes Toward HIV Testing in Pregnant Women in Ohio," was published in the journal AIDS Patient Care and STDs (2003;17:121-127).

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