D.N. Perlman and colleagues investigated within-group and between-group variations in prenatal HIV testing in a sample of low-income pregnant and recently postpartum women. The scientists used multivariable linear regression to estimate proportional differences in prenatal HIV testing for the total sample and stratified by race. "In bivariate analyses," the study said, "race and site of care jointly affected the probability of being tested."

The study found that predictors of prenatal testing differed by race. Hispanic women had the highest probability of being tested in public-practice settings. Relative to white women, black women had a higher probability of being tested in public and private practices. Receiving prenatal care in a community health center or hospital outpatient clinic increased the probability of testing for Hispanics, the authors reported, while being a recent victim of intimate partner violence was associated with less frequent testing for blacks. "Positive beliefs about HIV screening, while significant for blacks and Hispanics, was the only factor associated with testing for whites," the study found.

"Our data suggest that racial biases may be influencing providers' approach to testing, rather than CDC's 2001 guidelines for HIV screening of pregnant women. Study findings are being used to modify social marketing campaigns and improve provider trainings regarding prenatal HIV testing," the researchers concluded.

The report, "Disparities in Prenatal HIV Testing: Evidence for Improving Implementation of CDC Screening Guidelines," appeared in the Journal of the National Medical Association (2005;97(7 Suppl):44S-51S).

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