TUPE307 - Poster Exhibition
HIV medical provider´s assessment of the reproductive plans of women receiving HIV care
E. Valverde1, W. Short2, K. Brady3, E. Frazier1, L. Beer1, C. Mattson1
1Centers for Disease Control and Prevention, Atlanta, United States, 2Jefferson Medical College of Thomas Jefferson University, Philadelphia, United States, 3Philadelphia Department of Public Health, Philadelphia, United States
Background: HIV-infected pregnant women receiving optimal treatment have less than a 2% risk of vertical transmission to the infant. U.S. treatment guidelines recommend that providers regularly assess women´s reproductive plans and offer preconception counseling (PC) to reduce perinatal transmission and improve maternal outcomes if pregnancy is desired.
Methods: We analyzed data from the Medical Monitoring Project Provider Survey administered to a sample of HIV care providers in the U.S. between June and September 2009. We used multivariable logistic regression analysis to determine provider, patient, and practice characteristics associated with consistently offering PC to female patients living with HIV.
Results: Of 666 eligible survey respondents, 23% of providers were younger than 41 years of age, 51% were female, and 72% were white. The majority (69%) were medical doctors. Twenty-six percent (26%) reported consistently offering PC to female patients living with HIV. Asian (adjusted odds ratio [aOR]=2.3, 95% confidence interval [CI]=1.2-4.5) and Hispanic (aOR=2.7, CI=1.6-4.8) providers were more likely to engage in PC compared to white providers. Nurse practitioners were more likely to engage in PC (aOR=2.3, CI=1.4-3.7) compared to medical doctors. Providers having a >75% female practice were more likely to engage in PC compared to providers with a 25%-75% (aOR=0.4, 95% CI=0.2-0.9) or < 25% (aOR=0.2, CI=0.1-0.6) female practice. Finally, providers reporting sufficient time to provide all necessary HIV care information to their patients were more likely (aOR=1.6, CI=1.1-2.5) to consistently engage in PC compared to providers who reported insufficient time to do the same.
Discussion: Findings indicate that a minority of providers consistently engage in PC with their female patients. Interventions to improve consistent PC may need to target white providers, medical doctors, and practices with fewer HIV-infected women patients. Strategies to optimize time spent with patients so that all necessary HIV care information is communicated may also prove beneficial.
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