C through I), for instance, all point to a similar conclusion: testing does not necessarily lead to care, and even when it does, women are not necessarily receiving the quality treatment and services they need.

Getting Timely, Accurate, and Confidential Test Results

The committee repeatedly heard reports about the emotional difficulty of receiving positive HIV test results, even under ideal circumstances. For some women, however, the shock is intensified by the circumstances under which they are informed of their status. In Birmingham, Alabama, specialty care providers reported that some private providers test women without their knowledge and then relate positive results over the phone. By the time these women make their way to the specialty clinic, they are already distrustful of the health care system. Rebecca Denison, an HIV-positive mother who founded and is executive director of Women Organized to Respond to Life-threatening Diseases (WORLD) in Oakland, California, spoke of women who received calls from their physicians' offices telling them they had tested positive for HIV and that they should see a specialist since their own provider could not see them or ''could not tell them what the test results mean." The problem of health care providers being ill-equipped to inform and counsel HIV-infected women was also noted in San Antonio, Texas, where a case was cited in which an obviously nervous medical resident could not answer questions about care options. In another instance cited in San Antonio, an HIV-positive woman and her husband were shown lab results that they could not understand, and were given a prescription for ZDV and a pamphlet to read, but the woman's physician could not answer essential questions or give needed support.



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