PHYSICIANS PRACTICES AND OPINIONS REGARDING PRENATAL SCREENING FOR HUMAN-IMMUNODEFICIENCY-VIRUS AND OTHER SEXUALLY-TRANSMITTED DISEASES

Background and Objectives: Early prenatal diagnosis of sexually transm itted diseases (STDs), particularly human immunodeficiency virus (HIV) , is critical for maternal and infant health, We conducted a survey to assess physicians' prenatal STD screening practices and opinions. Stu dy Design: A random sample of obstetricians and family physicians was selected from the Minnesota Medical Association directory to complete a standardized telephone survey, Results: Eighty-three (86%) of 96 eli gible obstetricians and 94 (95%) of 99 eligible family physicians comp leted the survey. Nearly all physicians recommend universal prenatal s creening for syphilis (97%) and hepatitis B (99%); fewer physicians re commend prenatal screening for HIV (43%), chlamydia (26%), and gonorrh ea (24%). Adjusting for physicians' specialty, female physicians were more likely than male physicians to recommend universal prenatal HIV s creening (odds ratio [OR] = 2.1; 95% confidence interval [CI] = 1.1 -4 .2), Adjusting for physicians ages, physicians with more than 20% unin sured/Medical Assistance patients were more likely than other physicia ns to recommend prenatal gonorrhea screening (OR = 3.1; 95% CI = 1.4 - 6.8); similar factors were associated with chlamydia screening, Althou gh 89% of physicians supported universal prenatal HIV counseling and v oluntary screening, the median percentage of prenatal patients screene d for HIV was only 10%, Conclusions: Most physicians reported routinel y screening prenatal patients for syphilis and hepatitis B. Although m any physicians agreed with recommendations for universal prenatal HIV screening, their reported screening practices varied considerably from this approach.