Achieving universal HIV screening in prenatal care in the United States: Provider persistence pays off
Achieving universal HIV screening in prenatal care in the United States: Provider persistence pays off
复制标题
DOI：
10.1089/apc.2005.19.247
复制
发表时间：
2005-04-01
影响因子：
4.9
通讯作者：
Saul, J
中科院分区：
文献类型：
--
作者：
Anderson, JE;Koenig, LJ;Saul, J
建议美国所有孕妇进行常规自愿艾滋病毒检测，并有权拒绝（“选择退出”方法），但并非所有人都接受检测。我们检查了产前护理提供者调查的数据，以确定与患者普遍检测相关的因素。数据来自 1999 年对四个不同地区的产前护理人员进行的概率调查。调查参与者填写了一份自填问卷。我们根据提供者的实践特征、医学专业、他们鼓励检测的强烈程度、对患者风险的看法以及他们是否在公共诊所看诊患者，计算了报告普遍检测的提供者的百分比。在四个地点（纽约州布鲁克林、北卡罗来纳州、康涅狄格州和佛罗里达州戴德县），95% - 99% 的服务提供者表示，他们定期向所有孕妇提供艾滋病毒检测；测试的平均百分比为 64% - 89%。报告所有患者都接受了检测的百分比范围为 12% - 62%。报告普遍检测的提供者百分比与鼓励检测的程度呈正相关，特别是对被认为低风险的女性的鼓励。在某些地区，普遍检测因医疗专业而异，产科医生和住院医师以及护士助产士报告的普遍检测比例低于家庭医生和住院医生。为了实现对所有孕妇进行常规艾滋病毒检测的目标，必须向所有产前护理人员提供教育和培训。该培训应强调常规测试的重要性。即使采用选择退出的方法，如果医生不建议和鼓励艾滋病毒检测，许多女性也可能会拒绝检测。
Routine voluntary HIV testing with the right to decline ( the "opt-out" approach) is recommended for all pregnant women in the United States but not all are tested. We examined data from surveys of prenatal care providers to identify factors associated with universal testing among patients. Data are from a probability survey conducted in 1999 with prenatal care providers in four separate areas. Survey participants completed a self-administered questionnaire. We computed the percentage of providers reporting universal testing by characteristics of the provider's practice, medical specialty, how strongly they encouraged testing, perceptions of patients' risk, and whether they saw patients in public clinics. In the four locations ( Brooklyn, New York; North Carolina; Connecticut; and Dade County, Florida) 95% - 99% of providers reported that they routinely offered HIV testing to all pregnant women; the average percentage tested was 64% - 89%. The percentage reporting that all of their patients were tested ranged from 12% - 62%. The percent of providers reporting universal testing was positively associated with the degree to which testing was encouraged, particularly encouragement to women perceived to be low risk. In some areas, universal testing varied by medical profession, with obstetric physicians and residents, and nurse - midwives reporting a lower percentage of universal testing than family practice physicians and residents. To achieve the goal of routine HIV testing of all pregnant women, education and training must be delivered to all prenatal care providers. This training should emphasize the importance of routine testing. Even with the opt-out approach, many women may decline testing if their doctor does not recommend and encourage HIV testing.