Prenatal Care and HIV Infection

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Abstract
Recent use of zidovudine (ZDV) to reduce vertical transmission of HIV disease in newborns has demonstrated varied, but in some studies, dramatic results, with reports of reduction from approximately 8% to 25%. With this potential of efficacy in saving lives, knowledge of access to prenatal care for HIV-infected pregnant women is urgent. The current study used face-to-face and phone survey methods and employed a 77-item questionnaire to assess barriers to prenatal care in two groups of HIV-positive and HIV-negative women (n = 106). All participants had a child(ren) under 4 years of age and were currently enrolled in a primary care or family HIV clinic. Results showed that HIV-positive women had specific concerns regarding access of perinatal care that included disclosure and fear of anger from health care providers. Barriers such as transportation, insurance and child care, among others, were not predictive of the level of prenatal care received, but results may be biased by the small number of women who had not received adequate care and the general selection process from women who were currently attending clinics. A high level of prenatal care was recorded across both cohorts. Misconceptions about vertical transmission and ZDV efficacy were demonstrated, including that more than 80% of all participants stated there was a greater than 50% chance of a pregnant untreated HIV-positive woman transmitting the virus; the documented transmission rate for untreated birth mothers is 20% to 25%. In addition, HIV-negative women showed little knowledge about vertical transmission and the use of ZDV, putting this group at risk in the future. Better educational methods to more women about perinatal HIV transmission and ADV could be imperative in significantly improving reduction of vertical transmission.