Physiciansʼ Practices and Opinions Regarding Prenatal Screening for Human Immunodeficiency Virus and Other Sexually Transmitted Diseases

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Abstract
Early prenatal diagnosis of sexually transmitted 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. A random sample of obstetricians and family physicians was selected from the Minnesota Medical Association directory to complete a standardized telephone survey. Eighty-three (86%) of 96 eligible obstetricians and 94 (95%) of 99 eligible family physicians completed the survey. Nearly all physicians recommend universal prenatal screening for syphilis (97%) and hepatitis B (99%); fewer physicians recommend prenatal screening for HIV (43%), chlamydia (26%), and gonorrhea (24%). Adjusting for physicians' specialty, female physicians were more likely than male physicians to recommend universal prenatal HIV screening (odds ratio [OR] = 2.1; 95% confidence interval [CI] = 1.1-4.2). Adjusting for physicians' ages, physicians with more than 20% uninsured/Medical Assistance patients were more likely than other physicians to recommend prenatal gonorrhea screening (OR = 3.1; 95% CI = 1.4-6.8); similar factors were associated with chlamydia screening. Although 89% of physicians supported universal prenatal HIV counseling and voluntary screening, the median percentage of prenatal patients screened for HIV was only 10%. Most physicians reported routinely screening prenatal patients for syphilis and hepatitis B. Although many physicians agreed with recommendations for universal prenatal HIV screening, their reported screening practices varied considerably from this approach.