Concerns of Pregnant Women about Being Tested for HIV: A Study in a Predominately Mexican-American Population

Abstract

More than 90% of pediatric acquired immune deficiency syndrome (AIDS) cases are due to mother-to-child (vertical) transmission. Medical intervention can reduce the risk of vertical transmission human immunodeficiency virus (HIV) from 25% to less than 8%. However, studies have suggested that approximately one-fourth of women may refuse HIV testing as part of routine prenatal care. The purpose of this study was to identify concerns that pregnant women might have that would impact their decision to undergo HIV testing in pregnancy. The study is a cross-sectional survey of 413 pregnant women in south Texas. A survey questionnaire was used to assess reasons why subjects might avoid HIV testing and to assess their risks for HIV infection. The reasons for not wanting HIV testing grouped around four themes: (1) fear of being stigmatized as sexually promiscuous or as an injecting drug user; (2) denial about the possibility of being infected; (3) fatalism; and (4) of rejection leading to loss of emotional and financial support. Overall, 15% of subjects who had not been previously tested (5% of all subjects) indicated that they would refuse HIV testing, a rate which is below rates of 20%-24% in previous studies. The lower rate of refusal for HIV testing in our study may reflect a downward trend nationally in the rate of refusal for prenatal testing. Many women have concerns about HIV testing, although these concerns may not necessarily prevent them from undergoing testing. Physicians and policy makers need to be aware of women's concerns and fears when implementing HIV testing policies.

Cultural influences on HIV testing among Latino youth

“…Young people with strong familism value may view testing as a negative reflection on the family unit due to the stigma associated with HIV and the fear of sexual activity and orientation disclosure (Perez and Cruess 2014). In a sample of pregnant Latinas, concerns for being perceived as sexually promiscuous were the primary reason for not testing (Parra et al 2001). In a study of human papillomavirus vaccination, Latino parents exhibited a higher trend toward the belief that their daughters were not at risk for sexually transmitted infections compared to non-Latino parents (Watts et al 2009).…”

“…Studies on acculturation, assessed as place of birth, reported that US-born participants were more likely to have been tested for HIV (Chen, Gallant, and Page 2012;Oster et al 2013;Uribe et al 2009). Lower levels of acculturation, based on language use and preference, has been associated with lower likelihood of testing (Parra et al 2001). Among Latino participants in a population-based interview study, choosing to interview in Spanish was predictive of delayed testing after adjusting for age, education, drug injection and country of origin (Wohl, Tejero, and Frye 2009).…”

Attitudes About Prenatal Hiv Testing in Turkey

“…10 For this reason, it is recommended that each country should declare criteria for prenatal HIV testing according to the prevalence of AIDS in their country and then establish policies that should consider pregnant women's individual right of decision making, their willingness and their privacy and safety, and should also protect them from discrimination and stigmatization. 6,10,11 This study was designed to obtain verifiable data about attitudes and preferences of pregnant women and prenatal care providers towards prenatal HIV testing.…”

Factors influencing replacement feeding practices among HIV-positive mothers attending the PMTCT program at Uganda

“…Prevention of mother to child transmission of HIV (PMTCT) can be through provision of anti retroviral drugs (ARVs) and safe infant feeding counselling and practices [15,16] Despite the low cost for these short course ARV regimens, implementation of PMTCTprograms faces many challenges including low uptake of Voluntary Counselling and Testing (VCT) [17][18], failure to return for HIV test results, failure to return for follow up visits before starting antiretroviral therapy or lack of adherence to drugs [19], fear of husbands and relatives, stigmatization by the general public, denial of sero-status, non-disclosure of serostatus, lack of consistent information, pro-breastfeeding cultural beliefs, low literacy levels, poverty, and lack of alternative feeds [20].…”