Objective. The purpose of this study was to assess the factors associated w
ith acceptance of HIV testing during pregnancy on the part of women receivi
ng prenatal care at public clinics.
Methods. Trained interviewers recruited and interviewed 1,357 women receivi
ng prenatal care at clinics in Florida, Connecticut, and New York City.
Results. Eighty-six percent of participants reported having been tested or
having signed a consent form to be tested. Acceptance of testing was found
to be related to strong beliefs about the benefits of testing, knowledge ab
out vertical transmission, perceived provider endorsement of testing, and s
ocial support. Women who declined testing said they did so because they did
not perceive themselves to be at risk for HIV (21%) or they faced administ
rative difficulties (16%) with some aspect of the testing process (for exam
ple, scheduling, limited availability of pre-test counselors).
Conclusions. Acceptance rates can be increased when women understand the mo
des of vertical transmission and the role of medication regimens in prevent
ing transmission; believe that prenatal identification of HIV can promote t
he health of mother and child; and perceive their providers as strongly end
orsing testing. These points can be woven into a brief pre-test counseling
message and made a routine component of prenatal care.