Lindsay M K, Feng T I, Peterson H B, Slade B A, Willis S, Klein L
Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, Georgia.
Obstet Gynecol. 1991 Apr;77(4):599-603.
Women who receive little or no prenatal care are at increased risk of adverse pregnancy outcome. Although many of these women are disadvantaged and presumably at increased risk for human immunodeficiency virus (HIV) infection, few data are available to describe risk behaviors and infection prevalence in this population. To better characterize HIV infection in unregistered inner-city parturients in Atlanta, we offered routine voluntary screening for HIV antibody and requested HIV risk-behavior profiles on all unregistered and registered parturients seen at Grady Memorial Hospital from July 1, 1987 to June 30, 1988. Of the 834 unregistered and 7356 registered parturients screened, significantly more unregistered parturients were seropositive on enzyme-linked immunosorbent assay and Western blot testing, 12 (1.4%) versus 26 (0.4%) (odds ratio 4.06; 95% confidence interval 1.93-8.43). Five unregistered and 15 registered parturients were seropositive by repeat enzyme-linked immunosorbent assay testing but were Western blot-negative. Significantly more unregistered parturients reported both a history of intravenous drug use, 4.4 versus 1.5% (odds ratio 3.09; 95% confidence interval 2.10-4.54), and crack cocaine use, 3 versus 0.8% (odds ratio 3.96; 95% confidence interval 2.42-6.44). Significantly more unregistered parturients acknowledged risk factors for HIV infection, 14.3 versus 9.9% (odds ratio 1.46; 95% confidence interval 1.19-1.80). Nearly all registered and 86% of unregistered parturients consented to HIV testing. Nearly all parturients completed HIV risk-behavior questionnaires. These data suggest that unregistered inner-city parturients in Atlanta are at greater risk of being HIV-infected and are more likely to report risk behaviors for infection.
接受很少或没有产前护理的女性出现不良妊娠结局的风险会增加。尽管这些女性中有许多处于不利地位，并且感染人类免疫缺陷病毒（HIV）的风险可能更高，但几乎没有数据可用于描述该人群的风险行为和感染率。为了更好地描述亚特兰大市未登记的市中心产妇中的HIV感染情况，我们对1987年7月1日至1988年6月30日在格雷迪纪念医院就诊的所有未登记和已登记产妇进行了常规的HIV抗体自愿筛查，并要求提供HIV风险行为概况。在接受筛查的834名未登记产妇和7356名已登记产妇中，酶联免疫吸附测定和免疫印迹检测显示，未登记产妇的血清阳性率明显更高，分别为12例（1.4%）和26例（0.4%）（优势比4.06；95%置信区间1.93 - 8.43）。通过重复酶联免疫吸附测定检测，有5名未登记产妇和15名已登记产妇血清呈阳性，但免疫印迹检测为阴性。未登记产妇报告有静脉吸毒史的比例明显更高，分别为4.4%和1.5%（优势比3.09；95%置信区间2.10 - 4.54），使用快克可卡因的比例分别为3%和0.8%（优势比3.96；95%置信区间2.42 - 6.44）。未登记产妇承认有HIV感染风险因素的比例明显更高，分别为14.3%和9.9%（优势比1.46；95%置信区间1.19 - 1.80）。几乎所有已登记产妇和86%的未登记产妇都同意进行HIV检测。几乎所有产妇都完成了HIV风险行为问卷。这些数据表明，亚特兰大市未登记的市中心产妇感染HIV的风险更高，并且更有可能报告感染的风险行为。
