The Institute of Medicine recently recommended universal HIV testing as a routine component of prenatal care for all U.S. pregnant women. To date, no research has been done to examine how to enhance acceptance of universal, routine HIV testing for pregnant women who are considered to be the highest at risk for HIV infection and perinatal transmission: Black and Hispanic women. That is, if understanding and acceptance from pregnant women of color with this process are not commensurate with those of policymakers, they may forego utilizing prenatal care in a timely fashion. This study will explore U.S. pregnant women's perceptions of this change in testing policy using qualitative and quantitative research methods. Eighty individual interviews, 1-1/2 to 2 hours in length, will be conducted with U.S. Black, non-Hispanic and Hispanic pregnant women seeking prenatal care at community-based or hospital clinics in San Francisco, Washington, D.C., and Chapel Hill, North Carolina; 25 in San Francisco, 25 in Washington, D.C., and 30 in Chapel Hill. The interview instrument will consist of a sociodemographic questionnaire that includes HIV risk assessment questions, and a qualitative interview guide developed for this study. Research questions will be to (a) explore participants' experiences with current prenatal HIV testing procedures, and (b) identify pregnant women's perceived risks and benefits of universal, routine prenatal HIV testing under the new recommended policy. Interviews will be audiotaped and transcribed. Transcripts will be read to identify and code themes. Predicted themes (i.e., experiences with prenatal HIV testing and perceived risks/benefits of universal, routine HIV testing) and emergent themes will be used to develop written educational materials addressing pregnant women's concerns and priorities about HIV testing and treatment under this health policy change.
