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Reducing the Odds: Preventing Perinatal Transmission of HIV in the United States (1999)

Chapter: J Human Immunodeficiency Virus Antibody Testing Among Women 15-44: Results from the 1995 National Survey of Family Growth

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Suggested Citation:"J Human Immunodeficiency Virus Antibody Testing Among Women 15-44: Results from the 1995 National Survey of Family Growth." Institute of Medicine and National Research Council. 1999. Reducing the Odds: Preventing Perinatal Transmission of HIV in the United States. Washington, DC: The National Academies Press. doi: 10.17226/6307.
×

Appendix J Human Immunodeficiency Virus Antibody Testing Among Women 15–44: Results from the 1995 National Survey of Family Growth

Maria Hewitt

National estimates of the use of HIV tests among women of reproductive-age are available from the 1995 National Survey of Family Growth (NSFG) conducted by the National Center for Health Statistics (NCHS, 1997). As part of this survey, 10,847 women were interviewed in their homes from January to October 1995. The survey response rate was 79%. Interviews lasted an average of 103 minutes and covered the following topics: pregnancy and birth history, marriage and cohabitation history, sexual partner history, contraceptive use, diseases related to fertility (e.g., pelvic inflammatory disease, sexually transmitted diseases [STDs]), HIV-related behaviors, and use of HIV tests. To ensure the confidentiality of responses to potentially sensitive questions, a small part of the interview was self-administered. Women listened over headphones to questions on topics such as abortion, sex partner history, and HIV-related behaviors and entered answers directly into laptop computers. This technique, called audio-CASI (computer-assisted self-interviewing), improves reporting of sensitive behaviors (NCHS, 1997).

The tables that follow show HIV test use among women of childbearing age by selected sociodemographic characteristics, pregnancy status, and HIV risk status. HIV test use is shown for women who were pregnant at the time of the interview, had completed a pregnancy in the last year, or had received pre- or postnatal care within the last year (1,472 women representing 13% of the population were pregnant, or recently pregnant using these criteria; these women are referred to as "pregnant" in the tables).

HIV test use is also shown by HIV risk status. A total of 691 women representing an estimated 6% of the population report specific risk behaviors (e.g., injection drug use or sex with an injection drug user), or a moderate to high self-perceived

Suggested Citation:"J Human Immunodeficiency Virus Antibody Testing Among Women 15-44: Results from the 1995 National Survey of Family Growth." Institute of Medicine and National Research Council. 1999. Reducing the Odds: Preventing Perinatal Transmission of HIV in the United States. Washington, DC: The National Academies Press. doi: 10.17226/6307.
×

risk of being HIV-infected themselves or of having had sex with someone infected with HIV.

HIV test use is shown in three ways: (1) "all HIV tests" includes self-reported HIV tests and any mentions of blood donation since 1985; (2) "any self-reported HIV test" excludes mentions of blood donation when the respondent does not specifically report having had an HIV test; and (3) "HIV test in last 12 months" is limited to self-reported HIV testing.

All rates and population counts are weighted to provide national estimates. Variance estimates for these HIV test use rates and logistic regression model parameters were calculated using the Taylor series method taking into account the complex design of the survey (STATA statistical software).

Preliminary Findings

Self-Reported HIV Test Use Among Reproductive-Age Women
  • From 1990 to 1995, self-reported HIV test use increased from 26% to 35% among reproductive-age women (Table J.1).
  • In 1995, pregnant women were almost twice as likely as non-pregnant women to have been tested for HIV (60% versus 31%) (Table J.2).
  • Women at high-risk for HIV are almost twice as likely as those at low risk to have been tested for HIV (64% versus 33%). Similarly, there are high rates of HIV testing among women reporting at least one STD in their lifetime (53%) and women reporting six or more lifetime sex partners (49%) (Table J.3).
  • Nearly nine of ten pregnant women (87%) at high risk for HIV report having been tested for HIV. HIV testing occurred within the year for two-thirds of high-risk pregnant women (67%) (Table J.4).
Location of Self-Reported HIV Tests
  • The most common sites of HIV testing among reproductive-age women are private doctor's offices or heath maintenance organizations (HMOs) (46%), public health department or other clinics (27%), and hospitals (16%). Teenagers, those with lower educational attainment, and the poor are more likely to use public health department and other clinics than private doctor's offices or HMOs (Table J.5).
  • Pregnant women are more likely than non-pregnant women to have been tested in the last 12 months at a doctor's office or HMO (62% versus 48%) (Table J.8).
Suggested Citation:"J Human Immunodeficiency Virus Antibody Testing Among Women 15-44: Results from the 1995 National Survey of Family Growth." Institute of Medicine and National Research Council. 1999. Reducing the Odds: Preventing Perinatal Transmission of HIV in the United States. Washington, DC: The National Academies Press. doi: 10.17226/6307.
×

TABLE J.1 Number of Women 15–44 Years of Age and Percent Ever Tested for HIV, by Source of Test Information and Selected Demographic Characteristics: United States, 1990 and 1995a

 

 

 

Percent Ever Tested

 

Number of Women (thousands)

Self-Reported Testsb (standard error)

All Testsc (standard error)

Characteristic

1990

1995

1990

1995

1990

1995

All womend

58,381

60,201

25.6

34.7 (0.6)

34.9

47.9 (0.6)

Race and ethnicity

Hispanic

5,547

6,703

23.8

38.9 (1.8)

29.8

46.6 (1.5)

Black, not Hispanic

7,526

8,210

28.5

45.5 (1.3)

34.8

50.8 (1.4)

White, not Hispanic

42,836

42,521

25.4

32.2 (0.7)

35.8

48.1 (0.7)

Education

Less than 12 years

5,618

15,151

24.6

29.9 (1.2)

31.0

36.1 (1.2)

12 years

17,247

19,987

23.1

35.1 (0.9)

31.3

47.5 (1.0)

13 years or more

27,033

24,763

28.6

37.3 (0.9)

39.9

55.6 (0.86)

Marital status

Never married

20,123

22,679

26.0

31.1 (0.9)

35.7

44.2 (0.9)

Married

31,417

29,673

23.6

34.2 (0.8)

32.5

48.4 (0.8)

Formerly married

6,841

7,849

33.5

46.9 (1.3)

43.4

56.8 (1.3)

Suggested Citation:"J Human Immunodeficiency Virus Antibody Testing Among Women 15-44: Results from the 1995 National Survey of Family Growth." Institute of Medicine and National Research Council. 1999. Reducing the Odds: Preventing Perinatal Transmission of HIV in the United States. Washington, DC: The National Academies Press. doi: 10.17226/6307.
×

Age

15–19

8,483

8,924

21.5

20.9 (1.3)

28.7

29.0 (1.4)

20–24

9,154

8,946

27.0

40.3 (1.4)

40.8

55.5 (1.5)

25–29

10,637

9,795

33.4

44.6 (1.4)

40.9

60.1 (1.4)

30–34

11,091

10,982

27.5

42.0 (1.5)

37.1

54.6 (1.4)

35–39

10,111

11,297

22.0

33.3 (1.3)

31.5

46.0 (1.3)

40–44

8,905

10,014

20.3

26.4 (1.0)

28.5

41.3 (1.2)

Residence in metropolitan area

MSA, central city

12,727

18,551

31.9

39.8 (0.9)

39.9

51.3 (0.9)

MSA, other

29,981

29,303

26.1

33.5 (0.8)

36.4

47.7 (0.8)

Non-MSA

11,979

12,348

21.4

30.0 (1.5)

32.4

43.2 (1.5)

Region

Northeast

11,226

11,496

28.2

32.1 (1.2)

36.9

45.2 (1.5)

South

18,603

20,241

28.0

38.9 (1.1)

39.5

51.6 (1.0)

Midwest

14,453

14,525

23.8

29.4 (1.1)

34.0

44.3 (1.2)

West

10,405

13,938

25.4

36.3 (1.5)

33.5

48.5 (1.3)

Poverty-level income

0–149%

7,918

13,588

28.1

41.8 (1.2)

35.5

49.6 (1.2)

150% or more

41,980

46,613

25.9

32.6 (0.7)

36.0

47.4 (0.7)

NOTE: MSA = metropolitan statistical area.

a Data from 1990 from Wilson, 1993.

b Includes only test reported in response to the question: "Have you ever had your blood tested for infection with the AIDS virus?"

c Category includes all tests for HIV infection, including those done in connection with blood donation (i.e., all reporting a blood donation since March 1985).

d Includes women classified as "other" races, not shown separately because of small sample size.

Suggested Citation:"J Human Immunodeficiency Virus Antibody Testing Among Women 15-44: Results from the 1995 National Survey of Family Growth." Institute of Medicine and National Research Council. 1999. Reducing the Odds: Preventing Perinatal Transmission of HIV in the United States. Washington, DC: The National Academies Press. doi: 10.17226/6307.
×

TABLE J.2 Number of Women 15–44 Years of Age by Pregnancy Status, and Percent Tested for HIV, by Selected Demographic Characteristics: United States, 1995a

 

Number of Women (thousands)

HIV Test Last 12 Months (percent/standard error)

Any Self-Reported Testsb (percent/standard error)

Characteristic

Pregnant

Not Pregnant

Pregnant

Not Pregnant

Pregnant

Not Pregnant

All womenc

7,789

52,141

41.9 (1.4)

13.7 (0.4)

59.9 (1.5)

30.9 (0.6)

Race and ethnicity

Hispanic

1,245

5,448

47.4 (4.2)

16.1 (1.2)

60.3 (4.1)

33.9 (1.8)

Black, not Hispanic

1,166

7,032

55.5 (3.1)

24.3 (1.2)

71.4 (2.7)

41.2 (1.4)

White, not Hispanic

5,020

37,268

37.8 (1.8)

11.5 (0.5)

57.5 (2.1)

28.7 (0.7)

Education

Less than 12 years

2,025

13,081

54.5 (3.0)

13.0 (0.7)

69.2 (2.8)

23.8 (1.0)

12 years

2,655

17,250

42.1 (2.3)

14.0 (0.7)

59.4 (2.8)

31.3 (0.9)

13 years or more

3,075

21,545

33.6 (2.0)

13.8 (0.6)

54.2 (2.2)

34.9 (0.9)

Marital status

Never married

2,039

20,593

51.3 (2.8)

15.7 (0.7)

65.4 (2.8)

27.7 (0.9)

Married

5,024

24,457

36.1 (1.8)

10.2 (0.6)

55.2 (1.8)

29.8 (0.8)

Formerly married

726

7,092

55.8 (4.9)

19.8 (1.1)

77.1 (3.9)

43.8 (1.3)

Age

15–19

957

7,953

55.3 (4.0)

9.9 (0.9)

68.7 (4.2)

15.2 (1.1)

20–24

1,813

7,086

45.3 (3.1)

18.6 (1.2)

61.2 (3.2)

34.9 (1.5)

25–29

2,293

7,443

39.8 (2.9)

18.7 (1.2)

58.1 (2.8)

40.4 (1.6)

Suggested Citation:"J Human Immunodeficiency Virus Antibody Testing Among Women 15-44: Results from the 1995 National Survey of Family Growth." Institute of Medicine and National Research Council. 1999. Reducing the Odds: Preventing Perinatal Transmission of HIV in the United States. Washington, DC: The National Academies Press. doi: 10.17226/6307.
×

30–34

1,802

9,126

40.1 (2.9)

14.5 (0.9)

61.5 (3.1)

38.1 (1.5)

35–39

710

10,544

28.9 (4.2)

13.0 (0.8)

47.5 (5.0)

32.4 (1.3)

40–44

213

9,748

33.8 (8.2)

9.6 (0.8)

55.5 (8.2)

25.8 (1.0)

Residence in metropolitan area

MSA, central city

2,617

15,891

48.1 (2.6)

16.8 (0.8)

66.7 (2.4)

35.3 (0.9)

MSA, other

3,631

25,499

38.5 (2.0)

12.9 (0.6)

55.9 (2.3)

30.2 (0.8)

Non-MSA

1,542

10,750

39.4 (3.5)

11.0 (0.8)

57.8 (4.1)

26.0 (1.4)

Region

Northeast

1,431

10,009

40.2 (3.2)

12.9 (0.9)

58.6 (2.7)

28.3 (1.3)

South

2,587

17,569

51.6 (2.8)

16.0 (0.8)

70.3 (2.3)

34.3 (1.1)

Midwest

1,870

12,553

34.3 (2.3)

10.6 (0.8)

51.9 (3.2)

25.9 (1.1)

West

1,901

12,011

37.5 (3.2)

14.2 (0.9)

54.8 (3.7)

33.3 (1.4)

Poverty-level income

0–149%

2,306

11,250

51.1 (2.5)

17.6 (1.0)

66.5 (2.3)

36.7 (1.3)

150% or more

5,483

40,892

38.0 (1.7)

12.6 (0.5)

57.1 (1.8)

29.3 (0.7)

NOTE: MSA = metropolitan statistical area.

a A total of 1,472 survey respondents reported that they either were pregnant at the time of the interview (430), had completed a pregnancy within 12 months of the interview (1,039), or had received pre- or postnatal care in the last 12 months (1,140). Women referred to as ''pregnant" in this table are women who were pregnant, or recently pregnant, at the time of the interview.

b Includes only tests reported in response to the question: "Have you ever had your blood tested for infection with the AIDS virus?" Mentions of blood donation since 1985 are not included.

c Includes women classified as "other" races, not shown separately because of small sample size.

Suggested Citation:"J Human Immunodeficiency Virus Antibody Testing Among Women 15-44: Results from the 1995 National Survey of Family Growth." Institute of Medicine and National Research Council. 1999. Reducing the Odds: Preventing Perinatal Transmission of HIV in the United States. Washington, DC: The National Academies Press. doi: 10.17226/6307.
×

TABLE J.3 Number of Women 15–44 Years of Age Reporting AIDS Risk Behaviors, and Percent Ever Tested for HIV: United States, 1995

 

 

Percent Ever Tested

 

Characteristic

Number of Women (thousands)

Any Self-Reported Testa (standard error)

All Testsb (standard error)

All women

60,201

34.7 (0.6)

47.9 (0.6)

HIV risk

Moderate/high HIV riskc

3,672

63.9 (2.0)

68.5 (1.8)

Low HIV risk

56,528

32.8 (0.6)

46.6 (0.6)

STD history

At least one STD reported in lifetimed

6,218

53.2 (1.8)

66.2 (1.7)

No STD in lifetime

53,983

32.6 (0.7)

45.8 (0.6)

Number of sexual partners in lifetime

None

6,196

6.8 (0.8)

20.0 (1.6)

One

13,838

25.3 (1.0)

39.1 (1.1)

Two–five

22,655

37.5 (0.9)

50.6 (1.0)

Six–more

16,209

48.9 (1.0)

62.2 (1.0)

a Includes only tests reported in response to the question: "Have you ever had your blood tested for infection with the AIDS virus?"

b Category includes all tests for HIV infection, including those done in connection with blood donation (i.e., all reporting a blood donation since March 1985).

c Women reported whether they had a high, moderate, low, or no chance of being currently HIV-infected and whether they had a high, moderate, low, or no chance of having had sex with someone HIV-infected. Anyone indicating "high" or "moderate" on either question was categorized as at HIV-risk. In addition, during the audio-CASI portion of the interview, women reported whether they injected drugs in the last year, shared needles in the last year, or had a sex partner in the last year who had male partners, injected drugs, or shared needles. Any respondents answering yes to these questions were also categorized as at-risk. Using these criteria, 6% of women were categorized as at-risk (i.e., either self-identified as at-risk or reporting risk behaviors).

d Includes mention of gonorrhea, chlamydia, syphilis, genital warts, and genital herpes.

Reason for Self-Reported HIV Tests
  • The most common reason for HIV testing among reproductive-age women is "just to find out" (36%), as part of prenatal or pregnancy care (25%), and for a hospital procedure, referral by a doctor or other health provider contact (16%) (Table J.6).
  • Two-thirds of pregnant women (67%) cite pregnancy as the reason for HIV tests performed within the last 12 months (Table J.8).
Suggested Citation:"J Human Immunodeficiency Virus Antibody Testing Among Women 15-44: Results from the 1995 National Survey of Family Growth." Institute of Medicine and National Research Council. 1999. Reducing the Odds: Preventing Perinatal Transmission of HIV in the United States. Washington, DC: The National Academies Press. doi: 10.17226/6307.
×
Source of Referral for Self-Reported HIV Tests
  • When asked whose idea it was to get tested, 42% of reproductive-age women report a doctor or other health care provider, 39% report self, and 7% report an insurer (Table J.7).
  • Pregnant women are more than twice as likely as non-pregnant women to report that they were recently tested for HIV upon the recommendation of a health care provider (70% versus 30%) (Table J.8).
Factors Contributing to Test Use among Pregnant and Non-Pregnant Women
  • According to multivariate analyses, different factors are predictive of HIV test use for pregnant and non-pregnant women. Among women who are not pregnant, being at HIV risk, African American, poor, living in a metropolitan area, being age 20–39, highly educated, and having been formerly married increase HIV test use. Decreased HIV test use occurs among teenagers and residents of the Northeast and Midwest. Being at HIV risk triples the odds of HIV test use among non-pregnant women (Table J.9).
  • Among pregnant women, many of the sociodemographic predictors of HIV testing observed among non-pregnant women lose significance (i.e., age, race, poverty, and metropolitan area residence). This suggests that pregnancy is serving as a triggering event for testing, irrespective of the woman's characteristics. The role of education is reversed for pregnant women. Here, lower educational attainment is predictive of HIV testing. Different geographic patterns emerge for pregnant women, with residents of the South more likely to be tested than residents of other areas. Being at HIV risk quadruples the odds of HIV testing among pregnant women (Table J.9).

References

National Center for Health Statistics. Report of final mortality statics, 1995. Monthly Vital Statistics Report 1997; 45(11:Suppl 2).


Wilson JB. Human immunodeficiency virus antibody testing in women 15–44 years of age: United States, 1990. Advance Data from Vital and Health Statistics. Number 238, Hyattsville, Md.: National Center for Health Statistics, 1993.

Suggested Citation:"J Human Immunodeficiency Virus Antibody Testing Among Women 15-44: Results from the 1995 National Survey of Family Growth." Institute of Medicine and National Research Council. 1999. Reducing the Odds: Preventing Perinatal Transmission of HIV in the United States. Washington, DC: The National Academies Press. doi: 10.17226/6307.
×

TABLE J.4 Number of Women 15–44 Years of Age by Pregnancy Status and Percent Tested for HIV by Selected Measures of HIV Risk: United States, 1995a

 

Number of Women (thousands)

HIV Test Last 12 Months (percent/standard error)

Any Self-Reported Testb (percent/standard error)

Characteristic

Pregnant

Not Pregnant

Pregnant

Not Pregnant

Pregnant

Not Pregnant

All women

7,789

52,141

41.9 (1.4)

13.7 (0.4)

59.9 (1.5)

30.9 (0.6)

HIV risk

Report HIV-riskc

595

3,064

66.7 (4.5)

32.3 (2.4)

87.2 (3.6)

59.3 (2.3)

No report of HIV risk

7,194

49,078

39.9 (1.5)

12.5 (0.4)

57.6 (1.6)

29.1 (0.6)

STD history

At least 1 STD reported in lifetimed

1,022

5,162

44.3 (4.4)

21.1 (1.5)

69.3 (3.9)

50.0 (2.0)

No STD in lifetime

6,767

46,979

41.6 (1.5)

12.9 (0.5)

58.5 (1.5)

28.8 (0.7)

Suggested Citation:"J Human Immunodeficiency Virus Antibody Testing Among Women 15-44: Results from the 1995 National Survey of Family Growth." Institute of Medicine and National Research Council. 1999. Reducing the Odds: Preventing Perinatal Transmission of HIV in the United States. Washington, DC: The National Academies Press. doi: 10.17226/6307.
×

Number of sexual partners in lifetime

One

2,063

11,672

34.4 (2.7)

8.4 (0.7)

48.6

21.1 (0.9)

Two–five

3,416

19,142

43.7 (2.6)

15.0 (0.7)

60.6

33.4 (0.9)

Six-more

2,090

14,048

45.5 (2.8)

20.9 (0.9)

68.8

45.9 (1.0)

a A total of 1,472 survey respondents reported that they either were pregnant at the time of the interview (430), had completed a pregnancy within 12 months of the interview (1,039), or had received pre- or postnatal care in the last 12 months (1,140). Women referred to as "pregnant" in this table are to women who were pregnant, or recently pregnant, at the time of the interview.

b Includes only tests reported in response to the question: "Have you ever had your blood tested for infection with the AIDS virus?"

c Women reported whether they had a high, moderate, low, or no change of being currently HIV-infected and whether they had a high, moderate, low, or no chance of having had sex with someone HIV-infected. Anyone indicating "high" or ''moderate" on either question was categorized as at HIV-risk. In addition, during the audio-CASI portion of the interview, women reported whether they injected drugs in last year, shared needles in the last year, or had a sex partner in the last year who had male partners, injected drugs, or shared needles. Any respondents answering yes to these questions were also categorized as at-risk. Using these criteria, 6% of women were categorized as at-risk (i.e., either self-identified as at-risk or reporting risk behaviors).

d Includes mention of gonorrhea, chlamydia, syphilis, genital warts, and genital herpes.

Suggested Citation:"J Human Immunodeficiency Virus Antibody Testing Among Women 15-44: Results from the 1995 National Survey of Family Growth." Institute of Medicine and National Research Council. 1999. Reducing the Odds: Preventing Perinatal Transmission of HIV in the United States. Washington, DC: The National Academies Press. doi: 10.17226/6307.
×

TABLE J.5 Number of Women 15–44 Years of Age Self-Reporting Test for HIV and Percent Tested at Specific Locations for Most Recent Test, by Selected Demographic Characteristics: United States, 1995

 

 

Location of Most Recent HIV Test (percent/standard error)

Characteristic

Number of Women (thousands)

Private Doctor's Office or HMO

Public Health or Other Clinica

Hospital or Emergency Room

Other Locationb

All womenc

20,889

46.4 (0.1)

26.8 (0.9)

15.9 (0.7)

10.9 (0.6)

Race and ethnicity

Hispanic

2,606

41.8 (2.0)

36.6 (2.2)

14.1 (1.6)

7.6 (1.2)

Black, not Hispanic

3,734

40.1 (1.8)

38.6 (1.8)

15.0 (1.2)

6.3 (0.9)

White, not Hispanic

13,675

49.1 (1.3)

21.8 (1.1)

16.6 (0.9)

12.5 (0.8)

Education

Less than 12 years

4,533

36.7 (1.9)

41.3 (1.9)

16.8 (1.4)

5.2 (0.8)

12 years

7,014

48.1 (1.5)

26.0 (1.3)

15.9 (1.1)

10.0 (0.9)

13 years or more

9,244

49.8 (1.3)

20.2 (1.2)

15.6 (1.0)

14.4 (1.1)

Marital status

Never married

7,058

39.9 (1.8)

38.3 (1.7)

13.6 (1.2)

8.2 (0.9)

Married

10,149

50.9 (1.3)

18.6 (1.0)

16.6 (1.0)

13.9 (0.9)

Formerly married

3,682

46.3 (2.3)

27.7 (1.9)

18.3 (1.5)

7.7 (1.3)

Suggested Citation:"J Human Immunodeficiency Virus Antibody Testing Among Women 15-44: Results from the 1995 National Survey of Family Growth." Institute of Medicine and National Research Council. 1999. Reducing the Odds: Preventing Perinatal Transmission of HIV in the United States. Washington, DC: The National Academies Press. doi: 10.17226/6307.
×

Age

15–19

1,864

39.2 (2.9)

41.0 (2.7)

14.3 (2.1)

5.5 (1.2)

20–24

3,607

41.9 (2.3)

38.3 (2.1)

13.3 (1.6)

6.5 (1.2)

25–29

4,372

51.6 (2.0)

25.7 (1.9)

13.0 (1.6)

9.7 (1.1)

30–34

4,614

51.8 (1.8)

22.6 (1.6)

14.8 (1.4)

10.9 (1.2)

35–39

3,763

44.6 (2.1)

21.5 (1.7)

20.6 (1.6)

13.2 (1.6)

40–44

2,643

41.6 (2.3)

18.2 (2.0)

20.8 (1.9)

19.4 (1.9)

Residence in metropolitan area

MSA, central city

7,378

44.1 (1.5)

31.7 (1.5)

15.6 (1.0)

8.6 (1.0)

MSA, other

9,802

48.7 (1.3)

22.6 (1.1)

15.5 (0.9)

13.2 (0.8)

Non-MSA

3,709

44.8 (2.5)

28.4 (2.2)

17.8 (1.9)

9.0 (1.5)

Region

Northeast

3,686

42.5 (2.7)

25.4 (2.7)

18.2 (1.6)

13.8 (1.7)

South

7,876

46.4 (1.5)

29.4 (1.4)

15.3 (1.0)

8.8 (0.8)

Midwest

4,269

44.6 (2.5)

24.4 (1.8)

20.2 (2.0)

10.8 (1.5)

West

5,058

50.7 (1.4)

25.8 (1.5)

11.6 (1.0)

11.9 (1.0)

Poverty-level income

0–149%

5,685

36.5 (1.5)

41.1 (1.7)

16.1 (1.2)

6.4 (1.0)

150% or more

15,204

50.1 (1.1)

21.5 (1.0)

15.9 (0.8)

12.5 (0.7)

NOTE: MSA = metropolitan statistical area.

a Includes community clinics, family planning, public health, and other clinics.

b Includes other places such as school or college, military facility, home, job site, laboratory, or donation site.

c Includes women classified as "other" races, not shown separately because of small sample size.

Suggested Citation:"J Human Immunodeficiency Virus Antibody Testing Among Women 15-44: Results from the 1995 National Survey of Family Growth." Institute of Medicine and National Research Council. 1999. Reducing the Odds: Preventing Perinatal Transmission of HIV in the United States. Washington, DC: The National Academies Press. doi: 10.17226/6307.
×

TABLE J.6 Number of Women 15–44 Years of Age Self-Reporting Any Test for HIV and Percent Tested by Reason for the Last Test, by Selected Demographic Characteristics: United States, 1995

 

 

Reason for Last HIV Test (percent/standard error)

 

 

Characteristic

Number of Women (thousands)

HIV Test Only Reason for Visit

Pregnant, Prenatal Care

Hospital Procedure/ Referred by Doctora

Health/Life Insurance

Other Reasonb

All Womenc

20,889

35.8 (0.8)

25.0 (0.8)

15.5 (0.7)

8.5 (0.5)

15.2 (0.7)

Race and ethnicity

Hispanic

2,605

34.9 (2.5)

29.5 (2.5)

13.3 (1.4)

8.4 (1.3)

13.9 (1.6)

Black, not Hispanic

3,735

46.3 (1.6)

20.5 (1.4)

18.1 (1.2)

5.4 (0.8)

9.7 (1.0)

White, not Hispanic

13,674

33.6 (1.1)

25.3 (1.0)

15.3 (0.9)

9.6 (0.7)

16.2 (0.8)

Education

Less than 12 years

4,533

39.2 (1.8)

29.5 (1.6)

17.4 (1.3)

2.0 (0.5)

11.9 (1.3)

12 years

7,015

36.6 (1.5)

27.8 (1.4)

15.4 (1.1)

7.6 (0.8)

12.6 (1.0)

13 years or more

9,245

33.3 (1.4)

20.8 (1.0)

14.7 (1.0)

12.4 (0.9)

18.8 (1.1)

Marital status

Never married

7,058

50.8 (1.5)

17.7 (1.2)

15.1 (1.2)

4.0 (0.5)

12.5 (1.1)

Married

10,148

20.1 (1.1)

33.5 (1.3)

15.8 (0.9)

13.0 (0.9)

17.6 (1.0)

Formerly married

3,682

50.3 (2.3)

15.7 (1.6)

15.3 (1.4)

4.9 (1.2)

13.8 (1.4)

Suggested Citation:"J Human Immunodeficiency Virus Antibody Testing Among Women 15-44: Results from the 1995 National Survey of Family Growth." Institute of Medicine and National Research Council. 1999. Reducing the Odds: Preventing Perinatal Transmission of HIV in the United States. Washington, DC: The National Academies Press. doi: 10.17226/6307.
×

Age

15–19

1,866

47.3 (3.0)

24.3 (2.4)

16.3 (1.9)

1.5 (0.8)

10.6 (1.9)

20–24

3,606

40.2 (2.4)

32.8 (2.3)

10.5 (1.3)

3.0 (0.7)

13.5 (1.7)

25–29

4,373

36.3 (1.9)

31.5 (2.0)

12.4 (1.4)

6.9 (0.9)

13.0 (1.2)

30–34

4,614

28.8 (1.6)

29.1 (1.6)

15.9 (1.4)

10.8 (1.2)

15.5 (1.4)

35–39

3,765

33.0 (2.0)

17.5 (1.5)

20.3 (1.8)

11.9 (1.3)

17.3 (1.6)

40–44

2,644

37.0 (2.4)

7.8 (1.3)

19.5 (1.7)

15.1 (1.8)

20.5 (1.7)

Residence in metropolitan area

MSA, central city

7,377

39.5 (1.4)

24.5 (1.3)

15.3 (1.2)

6.6 (0.7)

14.1 (1.1)

MSA, other

9,803

33.7 (1.2)

24.7 (1.1)

14.9 (1.0)

10.2 (0.8)

16.6 (0.9)

Non-MSA

3,708

33.8 (2.3)

26.7 (2.3)

17.7 (1.7)

8.0 (1.3)

13.9 (1.6)

Region

Northeast

3,686

38.3 (1.9)

22.1 (1.9)

11.3 (1.2)

13.3 (1.5)

15.0 (1.5)

South

7,875

35.6 (1.3)

26.0 (1.4)

18.5 (1.0)

6.5 (0.7)

13.3 (1.1)

Midwest

4,268

30.5 (2.1)

26.8 (1.7)

16.6 (1.5)

8.2 (1.0)

17.9 (1.6)

West

5,058

38.6 (1.6)

24.0 (1.4)

12.9 (1.7)

8.5 (0.9)

16.0 (1.3)

Poverty-level income

0–149%

5,686

39.0 (1.7)

30.2 (1.6)

17.5 (1.4)

1.9 (0.4)

11.4 (1.2)

150% or more

15,204

34.6 (0.9)

23.1 (0.9)

14.8 (0.8)

11.0 (0.7)

16.6 (0.8)

NOTE: MSA = metropolitan statistical area.

a Includes being part of routine or general physical exam, and to start or renew birth control.

b Includes being part of a marriage license application, for employment, because potentially exposed to HIV, for immigration or visa application, and for school or college.

c Includes women classified as "other" races, not shown separately because of small sample size.

Suggested Citation:"J Human Immunodeficiency Virus Antibody Testing Among Women 15-44: Results from the 1995 National Survey of Family Growth." Institute of Medicine and National Research Council. 1999. Reducing the Odds: Preventing Perinatal Transmission of HIV in the United States. Washington, DC: The National Academies Press. doi: 10.17226/6307.
×

TABLE J.7 Number of Women 15–44 Years of Age Self-Reporting Any Test for HIV and Percent Tested by Referral Source for the Last Test, by Selected Demographic Characteristics: United States, 1995

 

 

Referral source (percent/standard error)

Characteristic

Number of Women (thousands)

Self

Health Care Providera

Insurer

Otherb

All womenc

20,889

39.3 (0.9)

42.4 (0.9)

7.3 (0.5)

10.9 (0.6)

Race and ethnicity

Hispanic

2,606

40.5 (2.5)

42.7 (2.2)

6.7 (1.0)

10.1 (1.1)

Black, not Hispanic

3,734

44.0 (1.8)

44.2 (1.9)

4.0 (0.7)

7.7 (0.9)

White, not Hispanic

13,675

38.2 (1.1)

41.9 (1.1)

8.5 (0.7)

11.4 (0.8)

Education

Less than 12 years

4,533

38.5 (1.8)

49.2 (1.7)

1.8 (0.5)

10.5 (1.2)

12 years

7,015

40.0 (1.6)

44.4 (1.5)

6.5 (0.7)

9.1 (0.9)

13 years or more

9,244

38.9 (1.2)

37.8 (1.2)

10.7 (0.9)

12.5 (0.9)

Marital status

Never married

7,057

49.7 (1.5)

36.3 (1.6)

3.2 (0.5)

10.7 (1.0)

Married

10,148

26.8 (1.2)

49.9 (1.4)

11.5 (0.8)

11.8 (0.8)

Formerly married

3,683

54.0 (2.2)

33.2 (2.0)

3.8 (1.0)

9.0 (1.3)

Age

15–19

1,865

42.8 (3.0)

41.9 (3.0)

1.5 (0.8)

13.9 (2.3)

20–24

3,606

41.9 (2.2)

44.8 (2.3)

2.9 (0.7)

10.5 (1.6)

25–29

4,372

39.2 (2.1)

46.9 (2.3)

5.9 (0.9)

8.0 (1.0)

30–34

4,615

35.7 (1.7)

45.3 (1.8)

9.0 (1.0)

10.0 (1.0)

35–39

3,764

37.9 (2.3)

39.5 (2.2)

9.8 (1.3)

12.8 (1.4)

40–44

2,643

41.8 (2.4)

31.5 (2.0)

13.7 (1.7)

13.0 (1.7)

Residence in metropolitan area

MSA, central city

7,378

42.4 (1.4)

41.6 (1.4)

5.9 (0.7)

10.1 (1.0)

MSA, other

9,803

38.8 (1.3)

40.9 (1.3)

8.7 (0.7)

11.5 (0.8)

Non-MSA

3,708

34.6 (2.3)

47.9 (2.1)

6.6 (1.2)

10.9 (1.4)

Region

Northeast

3,687

43.8 (2.1)

35.0 (2.0)

10.1 (1.2)

11.2 (1.3)

South

7,875

37.4 (1.3)

47.1 (1.4)

5.5 (0.7)

9.9 (0.9)

Midwest

4,268

33.2 (1.9)

45.3 (1.9)

7.4 (1.0)

14.0 (1.4)

West

5,057

44.2 (2.1)

38.0 (1.7)

8.1 (0.9)

9.8 (1.1)

Poverty-level income

0–149%

5,685

40.3 (1.6)

48.4 (1.6)

1.5 (0.4)

9.7 (1.1)

150% or more

15,203

39.0 (1.0)

40.1 (1.0)

9.5 (0.6)

11.4 (0.7)

NOTE: MSA = metropolitan statistical area.

a Includes women for whom the idea for testing came from a doctor, health department, and hospital or medical policy.

b Includes employer or school, government policy, sexual partner, and family or friends.

c Includes women classified as "other" races, not shown separately because of small sample size.

Suggested Citation:"J Human Immunodeficiency Virus Antibody Testing Among Women 15-44: Results from the 1995 National Survey of Family Growth." Institute of Medicine and National Research Council. 1999. Reducing the Odds: Preventing Perinatal Transmission of HIV in the United States. Washington, DC: The National Academies Press. doi: 10.17226/6307.
×

TABLE J.8 Number of Women 15–44 Years of Age by Pregnancy Status and Percent Tested for HIV In Last 12 Months by Location of Testing, Reason for Test, and Source of Referral for HIV Test: United States, 1995a

 

HIV Test Last 12 Months (percent/standard error)

 

Pregnant (n = 3,266)

Not Pregnant (n = 7,139)

Location of test

 

 

Private doctor's office or HMO

62.0 (2.1)

48.4 (1.6)

Public health or other clinicb

28.8 (1.9)

30.2 (1.5)

Hospital or emergency room

7.2 (1.2)

11.1 (1.0)

Other locationsc

2.0 (0.6)

10.4 (1.0)

Total

100.0

100.0

Reason for test

(n = 3,265)

(n = 7,139)

HIV test only reason for test

19.3 (1.8)

49.5 (1.5)

Pregnant, prenatal care

66.9 (2.1)

3.4 (0.5)

Hospital procedure/doctor referrald

7.3 (1.1)

22.0 (1.4)

Health/life insurance

2.9 (0.8)

9.1 (0.8)

Other reasone

3.6 (0.8)

16.0 (1.1)

Total

100.0

100.0

Source of referral for test

(n = 3,265)

(n = 7,139)

Self

24.6 (1.8)

51.0 (1.5)

Health care providerf

70.0 (2.0)

30.1 (1.4)

Insurer

2.3 (0.7)

7.6 (0.8)

Otherg

3.1 (0.8)

11.3 (1.1)

Total

100.0

100.0

a A total of 1,472 survey respondents reported that they either were pregnant at the time of the interview (430), had completed a pregnancy within 12 months of the interview (1,039), or had received pre- or postnatal care in the last 12 months (1,140). Women referred to as "pregnant" in this table are to women who were pregnant, or recently pregnant, at the time of the interview.

b Includes community, family planning, public health, and other clinics.

c Includes other places such as school or college, military facility, home, job site, laboratory, or donation site.

d Includes being part of routine or general physical exam, and to start or renew birth control.

e Includes being part of a marriage license application, for employment, because potentially exposed to HIV, for immigration or visa application, and for school or college.

f Includes women for whom the idea for testing came from a doctor, health department, or hospital or medical policy.

g Includes employer or school, government policy, sexual partner, and family or friends.

Suggested Citation:"J Human Immunodeficiency Virus Antibody Testing Among Women 15-44: Results from the 1995 National Survey of Family Growth." Institute of Medicine and National Research Council. 1999. Reducing the Odds: Preventing Perinatal Transmission of HIV in the United States. Washington, DC: The National Academies Press. doi: 10.17226/6307.
×

TABLE J.9 Logistic Regression Model, Predictors of Any Self-Reported HIV Test Among Women by Pregnancy Status, United States, 1995a,b

 

Odds Ratio Coefficient (95 percent confidence interval)

 

Model Parameter

Not Pregnant

Pregnant

Not Pregnant

Pregnant

Intercept

-1.2975

-0.4283

 

 

Race/ethnicity

Black

0.4234*

0.2025

1.53 (1.33–1.76)

1.22 (0.86–1.74)

Hispanic

0.0777

-0.1010

1.08 (0.89–1.31)

0.90 (0.61–1.35)

Other race

-0.1686

-0.0903

0.84 (0.59–1.21)

0.91 (0.50–1.68)

White, not Hispanic

 

 

Marital status

Never married

-0.0476

0.0857

0.95 (0.82–1.12)

1.09 (0.77–1.55)

Formerly married

0.4834*

0.8050*

1.62 (1.42–1.86)

2.24 (1.36–3.68)

Married

 

 

Residence in metro area

MSA central

0.3227*

0.2823

1.38 (1.16–1.65)

1.33 (0.88–2.00)

MSA other

0.2110*

-0.0058

1.23 (1.03–1.47)

0.99 (0.66–1.51)

non-MSA

 

 

Residence-region

Northeast

-0.2373*

0.1695

0.79 (0.66–0.94)

1.18 (0.80–1.74)

Midwest

-0.3624*

-0.0715

0.70 (0.59–0.82)

0.93 (0.61–1.43)

South

0.0078

0.5909*

1.01 (0.86–1.18)

1.81 (1.20–2.71)

West

 

 

Poverty

0–149%

0.1634*

0.0156

1.18 (1.03–1.34)

1.02 (0.75–1.37)

150% or more

 

 

Years of education

Less than 12 years

-0.2251*

0.4254*

0.80 (0.67–0.94)

1.53 (1.03–2.26)

12 years

-0.2379*

0.1374

0.79 (0.71–0.87)

1.15 (0.86–1.53)

13 years or more

 

 

Age

15–19

-0.4555*

0.2697

0.63 (0.46–0.88)

1.31 (0.52–3.29)

20–24

0.5249*

0.1734

1.69 (1.37–2.09)

1.19 (0.55–2.55)

25–29

0.6969*

0.1901

2.01 (1.69–2.39)

1.21 (0.56–2.61)

30–34

0.5974*

0.4478

1.82 (1.54–2.14)

1.56 (0.75–3.28)

35–39

0.3486*

-0.2564

1.42 (1.21–1.65)

0.77 (0.35–1.70)

40–44

 

 

Suggested Citation:"J Human Immunodeficiency Virus Antibody Testing Among Women 15-44: Results from the 1995 National Survey of Family Growth." Institute of Medicine and National Research Council. 1999. Reducing the Odds: Preventing Perinatal Transmission of HIV in the United States. Washington, DC: The National Academies Press. doi: 10.17226/6307.
×

 

Odds Ratio Coefficient (95 percent confidence interval)

 

Model Parameter

Not Pregnant

Pregnant

Not Pregnant

Pregnant

HIV risk

Moderate/high HIV risk

1.2189*

1.4694*

3.38 (2.77–4.13)

4.34 (2.25–8.41)

Low HIV risk

 

 

NOTE: MSA = metropolitan statistical area.

a Both logistic regression models provide a significant fit to the data (p < .00001). For not pregnant women, the model classifies 71 percent of the observed values correctly. For pregnant women, the model classifies 63% of the observed values correctly. Starred coefficients (*) denote statistical significance at p = .05.

b A total of 1,472 survey respondents reported that they were either pregnant at the time of the interview (430), had completed a pregnancy with 12 months of the interview (1,039), or had received pre- or postnatal care in the last 12 months (1,140). Women referred to as "pregnant" in this table refer to women who were pregnant, or recently pregnant, at the time of the interview.

Suggested Citation:"J Human Immunodeficiency Virus Antibody Testing Among Women 15-44: Results from the 1995 National Survey of Family Growth." Institute of Medicine and National Research Council. 1999. Reducing the Odds: Preventing Perinatal Transmission of HIV in the United States. Washington, DC: The National Academies Press. doi: 10.17226/6307.
×
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Suggested Citation:"J Human Immunodeficiency Virus Antibody Testing Among Women 15-44: Results from the 1995 National Survey of Family Growth." Institute of Medicine and National Research Council. 1999. Reducing the Odds: Preventing Perinatal Transmission of HIV in the United States. Washington, DC: The National Academies Press. doi: 10.17226/6307.
×
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Suggested Citation:"J Human Immunodeficiency Virus Antibody Testing Among Women 15-44: Results from the 1995 National Survey of Family Growth." Institute of Medicine and National Research Council. 1999. Reducing the Odds: Preventing Perinatal Transmission of HIV in the United States. Washington, DC: The National Academies Press. doi: 10.17226/6307.
×
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Suggested Citation:"J Human Immunodeficiency Virus Antibody Testing Among Women 15-44: Results from the 1995 National Survey of Family Growth." Institute of Medicine and National Research Council. 1999. Reducing the Odds: Preventing Perinatal Transmission of HIV in the United States. Washington, DC: The National Academies Press. doi: 10.17226/6307.
×
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Suggested Citation:"J Human Immunodeficiency Virus Antibody Testing Among Women 15-44: Results from the 1995 National Survey of Family Growth." Institute of Medicine and National Research Council. 1999. Reducing the Odds: Preventing Perinatal Transmission of HIV in the United States. Washington, DC: The National Academies Press. doi: 10.17226/6307.
×
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Suggested Citation:"J Human Immunodeficiency Virus Antibody Testing Among Women 15-44: Results from the 1995 National Survey of Family Growth." Institute of Medicine and National Research Council. 1999. Reducing the Odds: Preventing Perinatal Transmission of HIV in the United States. Washington, DC: The National Academies Press. doi: 10.17226/6307.
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Suggested Citation:"J Human Immunodeficiency Virus Antibody Testing Among Women 15-44: Results from the 1995 National Survey of Family Growth." Institute of Medicine and National Research Council. 1999. Reducing the Odds: Preventing Perinatal Transmission of HIV in the United States. Washington, DC: The National Academies Press. doi: 10.17226/6307.
×
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Suggested Citation:"J Human Immunodeficiency Virus Antibody Testing Among Women 15-44: Results from the 1995 National Survey of Family Growth." Institute of Medicine and National Research Council. 1999. Reducing the Odds: Preventing Perinatal Transmission of HIV in the United States. Washington, DC: The National Academies Press. doi: 10.17226/6307.
×
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Suggested Citation:"J Human Immunodeficiency Virus Antibody Testing Among Women 15-44: Results from the 1995 National Survey of Family Growth." Institute of Medicine and National Research Council. 1999. Reducing the Odds: Preventing Perinatal Transmission of HIV in the United States. Washington, DC: The National Academies Press. doi: 10.17226/6307.
×
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Suggested Citation:"J Human Immunodeficiency Virus Antibody Testing Among Women 15-44: Results from the 1995 National Survey of Family Growth." Institute of Medicine and National Research Council. 1999. Reducing the Odds: Preventing Perinatal Transmission of HIV in the United States. Washington, DC: The National Academies Press. doi: 10.17226/6307.
×
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Suggested Citation:"J Human Immunodeficiency Virus Antibody Testing Among Women 15-44: Results from the 1995 National Survey of Family Growth." Institute of Medicine and National Research Council. 1999. Reducing the Odds: Preventing Perinatal Transmission of HIV in the United States. Washington, DC: The National Academies Press. doi: 10.17226/6307.
×
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Suggested Citation:"J Human Immunodeficiency Virus Antibody Testing Among Women 15-44: Results from the 1995 National Survey of Family Growth." Institute of Medicine and National Research Council. 1999. Reducing the Odds: Preventing Perinatal Transmission of HIV in the United States. Washington, DC: The National Academies Press. doi: 10.17226/6307.
×
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Suggested Citation:"J Human Immunodeficiency Virus Antibody Testing Among Women 15-44: Results from the 1995 National Survey of Family Growth." Institute of Medicine and National Research Council. 1999. Reducing the Odds: Preventing Perinatal Transmission of HIV in the United States. Washington, DC: The National Academies Press. doi: 10.17226/6307.
×
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Suggested Citation:"J Human Immunodeficiency Virus Antibody Testing Among Women 15-44: Results from the 1995 National Survey of Family Growth." Institute of Medicine and National Research Council. 1999. Reducing the Odds: Preventing Perinatal Transmission of HIV in the United States. Washington, DC: The National Academies Press. doi: 10.17226/6307.
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Suggested Citation:"J Human Immunodeficiency Virus Antibody Testing Among Women 15-44: Results from the 1995 National Survey of Family Growth." Institute of Medicine and National Research Council. 1999. Reducing the Odds: Preventing Perinatal Transmission of HIV in the United States. Washington, DC: The National Academies Press. doi: 10.17226/6307.
×
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Suggested Citation:"J Human Immunodeficiency Virus Antibody Testing Among Women 15-44: Results from the 1995 National Survey of Family Growth." Institute of Medicine and National Research Council. 1999. Reducing the Odds: Preventing Perinatal Transmission of HIV in the United States. Washington, DC: The National Academies Press. doi: 10.17226/6307.
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Suggested Citation:"J Human Immunodeficiency Virus Antibody Testing Among Women 15-44: Results from the 1995 National Survey of Family Growth." Institute of Medicine and National Research Council. 1999. Reducing the Odds: Preventing Perinatal Transmission of HIV in the United States. Washington, DC: The National Academies Press. doi: 10.17226/6307.
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Suggested Citation:"J Human Immunodeficiency Virus Antibody Testing Among Women 15-44: Results from the 1995 National Survey of Family Growth." Institute of Medicine and National Research Council. 1999. Reducing the Odds: Preventing Perinatal Transmission of HIV in the United States. Washington, DC: The National Academies Press. doi: 10.17226/6307.
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Reducing the Odds: Preventing Perinatal Transmission of HIV in the United States Get This Book
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Thousands of HIV-positive women give birth every year. Further, because many pregnant women are not tested for HIV and therefore do not receive treatment, the number of children born with HIV is still unacceptably high. What can we do to eliminate this tragic and costly inheritance? In response to a congressional request, this book evaluates the extent to which state efforts have been effective in reducing the perinatal transmission of HIV. The committee recommends that testing HIV be a routine part of prenatal care, and that health care providers notify women that HIV testing is part of the usual array of prenatal tests and that they have an opportunity to refuse the HIV test. This approach could help both reduce the number of pediatric AIDS cases and improve treatment for mothers with AIDS.

Reducing the Odds will be of special interest to federal, state, and local health policymakers, prenatal care providers, maternal and child health specialists, public health practitioners, and advocates for HIV/AIDS patients. January

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