STI screening, HIV testing lacking among married women
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Married women are less likely to receive sexually transmitted disease counseling and HIV testing in the year before a pregnancy compared with unmarried women, according to research presented at IDWeek 2022.
“The objective of this study was to examine health care visit practices among women before pregnancy and compare the pre-pregnancy STI counseling and HIV testing rates across the U.S.,” Eun Ji Jang, MD, a pediatric infectious disease fellow at Brown University/Hasbro Children's Hospital, said during the presentation. “And [also] comparing STI counseling and HIV testing rates among married and unmarried women before pregnancy, and also identifying other characteristics of women who have missed these screenings.”
Jang and colleagues analyzed data from the 2016-2019 Pregnancy Risk Assessment Monitoring System, a population-based postpartum survey of women from 43 states, including Puerto Rico and the District of Columbia.
The researchers examined patients’ marital status and self-reported information on whether or not they spoke with a health care worker about STI testing and if they underwent HIV testing in the 12 months before their pregnancy. They also completed multivariable logistical regression analyses after adjusting for age, race, Hispanic ethnicity, insurance, income, education and previous live birth.
Among the 162,558 women surveyed, 66.1% had a health care visit in the 12 months before their pregnancy.
Of the 104,256 women who had a health care visit and responded to survey questions regarding STI screening, 70% reported that they did not receive STI counseling or HIV testing in the year before their pregnancy.
Jang and colleagues determined that the District of Columbia and Puerto Rico had the highest rate of pre-pregnancy screening and Utah had the lowest.
They also found that, compared with unmarried women, married women were less likely to receive pre-pregnancy STI counseling (OR = 0.6; 95% CI, 0.56-0.64) and HIV testing (OR = 0.65; 95% CI, 0.61-0.69).
The researchers determined that older age, more education, having private insurance, higher income and previous live birth were risk factors for not receiving pre-pregnancy STI screening.
Additionally, they found that Black and Hispanic women were two to three times more likely to undergo STI screening compared with white women, according to Jang.
“Selective STI counseling and HIV testing creates missed opportunities to address STI screening early before pregnancy, so universal testing should be adopted for all women, regardless of their preconceived risk or assumptions,” Jang said.
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Jang EJ, et al. Abstract 2215. Presented at IDWeek; Oct 19-23, 2022; Washington (hybrid meeting).
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