Roome A, Carley K, Melchreit R, Foye G, Hadler J
Connecticut Department of Public Health, Hartford, USA.
Conn Med. 1999 Sep;63(9):523-9.
High rates of prenatal testing are needed to identify all HIV-infected pregnant women and prevent transmission to their offspring. To evaluate HIV testing of pregnant women in Connecticut, a survey was conducted in 1998 of licensed obstetricians and a review was performed of 992 randomly sampled prenatal and obstetric medical records for births occurring in 1996. Results of the survey indicated that 78.8% of respondents routinely offered HIV counseling and 76.4% routinely offered HIV testing to pregnant patients in 1997. However, only 44% reported that greater than half of their patients were being tested. Providers who had an HIV testing policy that included HIV-testing unless the patient refused had the highest rate (80.8%; P < 0.05). The review of medical records revealed that only 28.8% of women who delivered in 1996 had an HIV test performed during prenatal care. Maternal characteristics associated (P < 0.05) with testing included Hispanic ethnicity (51.8% tested), younger age (53.6%, < 20 years old), having Medicaid (48.0%), hospital clinic services (44.6%), and history of intravenous drug use (IDU) (76.9%). Testing rate varied by hospital from 0% to 82.8%. These results indicate that considerable modification of provider and hospital practices and policies is needed to raise HIV screening rates.
需要进行高比例的产前检测，以识别所有感染艾滋病毒的孕妇，并防止病毒传播给她们的后代。为评估康涅狄格州孕妇的艾滋病毒检测情况，1998年对持照产科医生进行了一项调查，并对1996年出生的992份随机抽取的产前和产科病历进行了审查。调查结果显示，1997年78.8%的受访者会定期为孕妇提供艾滋病毒咨询，76.4%的受访者会定期为孕妇提供艾滋病毒检测。然而，只有44%的受访者报告称，超过一半的患者接受了检测。有艾滋病毒检测政策（包括除非患者拒绝否则进行艾滋病毒检测）的医疗服务提供者检测率最高（80.8%；P<0.05）。病历审查显示，1996年分娩的女性中，只有28.8%在产前护理期间进行了艾滋病毒检测。与检测相关（P<0.05）的产妇特征包括西班牙裔（检测率为51.8%）、年龄较小（53.6%，<20岁）、有医疗补助（48.0%）、使用医院门诊服务（44.6%）以及有静脉吸毒史（76.9%）。不同医院的检测率从0%到82.8%不等。这些结果表明，需要对医疗服务提供者和医院的做法及政策进行大幅调整，以提高艾滋病毒筛查率。
