[TuPeC4766] Women who deliver with no prenatal care: the importance of offering rapid testing

14th International AIDS Conference

Barcelona, Spain — July 7-12, 2002

[TITLE:] Women who deliver with no prenatal care: the importance of offering rapid testing

[AUTHOR(S):] R. Maupin, J. Fatsis, J. Miller¹, P. Kissinger, R.M. Lynam , E. Prystowsky, A. Nguyen²

Int Conf AIDS. 2002 Jul 7-12;14:Abstract No. TuPeC4766

BACKGROUND: Prenatal screening for HIV and early initiation of perinatal prophylaxis is the cornerstone of perinatal HIV eradication. Despite the widespread availability in the United States, certain women do not avail themselves of prenatal care (including HIV testing). The purpose of this study was to compare women who delivered at University Hospital in New Orleans who did and did not receive prenatal care.

METHODS: 133 women who received no prenatal care (NPC) during 1999 were matched with 133 women who attended at least 3 prenatal visits. During the time of this study, women who had not previously been tested were offered the rapid HIV test (i.e. SUDS). Medical records were reviewed for demographic, clinical, STD and substance abuse information. Bivariate and multivariable logistic regression was done.

RESULTS: Of the 266 women studied, 87% were African American, 53% had no insurance, 87% were single, 57% were > 21 years of age, 70% were unemployed, 78% were tested for street drugs (27% tested positive), 72% were tested for gonnorrhea and chlamydia (4.6% and 8.9% were positive respectively) and 94% were tested for HIV (~2% tested positive). In bivariate analysis, women who had NPC were less likely to have insurance (O.R. 0.39), more likely to be smokers (O.R. 2.71), have delivered other children (O.R. 5.55), have a history of drug abuse (O.R. 2.1), have positive toxicology tests for cocaine (O.R. 6.98), opiates (O.R. 2.24) and barbiturates (O.R. 3.46), and test positive for syphilis (O.R. 6.57). When these variables were considered in multivariable analysis, women who had NPC were more likely to not have insurance O.R. 2.61 (1.53 - 4.47) and to have at least one child O.R. 4.67 (2.45 - 8.93).

Conclusion: Many women who do not attend prenatal care are at high-risk for HIV and may go untested. Outreach to these woman, coupled with rapid testing and emergent initiation of perinatal prophylaxis if positive should be a priority public health goal.

Presenting author: Patty Kissinger

1Louisiana State University, 1440 Canal Street, Department of Epi/SL-18, New Orleans, Lousiana 70112, United States.

2Tulane University SPHTM, New Orleans, United States.

020708
TuPeC4766