C. Limata et al., COMPLIANCE WITH VOLUNTARY PRENATAL HIV TESTING IN A LARGE HEALTH MAINTENANCE ORGANIZATION (HMO), Journal of acquired immune deficiency syndromes and human retrovirology, 15(2), 1997, pp. 126-130
Results of a recent national clinical trial show that maternal-to-feta
l transfer of HIV can be decreased threefold by prenatal, intrapartum,
and neonatal treatment. The question is whether to make prenatal HIV
testing compulsory or to encourage voluntary testing. Kaiser Permanent
e Northern California (KPNC), which has 2.5 million members, is part o
f a large health maintenance organization (HMO). In 1994, KPNC cared f
or 32,700 prenatal patients; 16,500 (50%) agreed to voluntary HIV test
ing. Compliance with testing ranged from 0% to 92% among the 31 KPNC l
ocations. A study done by telephone survey identified three main facto
rs favoring success of voluntary HIV screening: the ease and accessibi
lity of HIV testing, a designated educator, and the presence of a regi
stered nurse on the counseling team. In 1995, following feedback to th
e 31 facilities of the 1994 results, compliance rose to 19,800 of 31,3
00 prenatal patients (63%). KPNC, by encouraging counseled voluntary s
creening and following known positive cases, hopes to identify, track,
and offer treatment options to all HIV-positive prenatal patients.