Tufts University School of Medicine, Boston, MA, USA.
2829Wright State University Boonshoft School of Medicine, Fairborn, OH, USA.
J Int Assoc Provid AIDS Care. 2022 Jan-Dec;21:23259582211069767. doi: 10.1177/23259582211069767.
Prenatal HIV screening is critical to eliminate mother-to-child (MTC) HIV transmission. Although Massachusetts (MA) has near-zero MTC transmission rates, recent trends in statewide prenatal HIV testing are unknown. This study examined variations in prenatal HIV screening across race/ethnicity, socioeconomic status, and prenatal care settings in MA, in the period following national and state-level changes in guidance encouraging routine prenatal HIV testing.According to the MA Pregnancy Risk Assessment Monitoring System (PRAMS) data, 68.3% of pregnant women in MA were screened for HIV between 2007 and 2016. There were significant differences in prenatal screening rates across race/ethnicity, with 83.38% of Black non-Hispanic (NH), 85.5% of Hispanic women, and 62.4% of White NH women reporting being tested for HIV at some point during their pregnancy ( <.0001). Multivariate regression found that differences in screening were explained by race/ethnicity, Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) status, prenatal care site, type of insurance, nativity, and marital status. Annual rates of prenatal HIV screening did not change significantly in MA from 2007 to 2016 ( = .27).The results of the analysis revealed that prenatal HIV screening rates differ based on race/ethnicity, with higher rates in Black NH and Hispanic women when compared to White NH women. The racial disparities in prenatal HIV screening and lack of universal screening in MA raises questions about the effectiveness of the state's approach.
产前 HIV 筛查对于消除母婴传播（MTC）至关重要。尽管马萨诸塞州（MA）的 MTC 传播率接近零，但目前尚不清楚全州范围内产前 HIV 检测的最新趋势。本研究调查了 MA 产前 HIV 筛查在种族/族裔、社会经济地位和产前保健环境方面的变化，该研究发生在全国和州级指南发生变化后，鼓励常规进行产前 HIV 检测。
根据 MA 妊娠风险评估监测系统（PRAMS）的数据，2007 年至 2016 年间，MA 有 68.3%的孕妇接受了 HIV 筛查。不同种族/族裔之间的产前筛查率存在显著差异，黑人非西班牙裔（NH）的比例为 83.38%，西班牙裔女性为 85.5%，白人 NH 女性为 62.4%，报告在怀孕期间的某个时候接受过 HIV 检测（<.0001）。多变量回归发现，筛查差异可以通过种族/族裔、妇女、婴儿和儿童特别补充营养计划（WIC）状况、产前保健场所、保险类型、出生地和婚姻状况来解释。从 2007 年到 2016 年，MA 产前 HIV 筛查的年度率没有显著变化（ = .27）。
分析结果表明，产前 HIV 筛查率因种族/族裔而异，与白人 NH 女性相比，黑人 NH 和西班牙裔女性的筛查率更高。在 MA 中，产前 HIV 筛查的种族差异以及缺乏普遍筛查引发了人们对该州方法有效性的质疑。
