Patient Perspectives with Abbreviated versus Standard Pre-Test HIV Counseling in the Prenatal Setting A Randomized-Controlled, Non-Inferiority Trial 英文参考文献.docVIP

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Patient Perspectives with Abbreviated versus Standard Pre-Test HIV Counseling in the Prenatal Setting A Randomized-Controlled, Non-Inferiority Trial 英文参考文献.doc

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Patient Perspectives with Abbreviated versus Standard Pre-Test HIV Counseling in the Prenatal Setting A Randomized-Controlled, Non-Inferiority Trial 英文参考文献

PatientPerspectiveswithAbbreviatedversusStandard Pre-TestHIVCounselinginthePrenatalSetting:A Randomized-Controlled,Non-InferiorityTrial DeborahCohan1*,ElviraGomez1,MaraGreenberg2,SierraWashington1,EdwinD.Charlebois3 1DepartmentofObstetrics,Gynecology,ReproductiveSciences,UniversityofCaliforniaSanFrancisco,SanFrancisco,California,UnitedStatesofAmerica,2Department ofObstetricsandGynecology,StanfordUniversity,PaloAlto,California,UnitedStatesofAmerica,3DepartmentofMedicine,UniversityofCaliforniaSanFrancisco,San Francisco,California,UnitedStatesofAmerica Abstract Background: In the US, an unacceptably high percentage of pregnant women do not undergo prenatal HIV testing. PreviousstudieshavefoundincreaseduptakeofprenatalHIVtestingwithabbreviatedpre-testcounseling,howeverlittleis knownaboutpatientdecisionmaking,testingsatisfactionandknowledgeinthissetting. Methodology/Findings:Arandomized-controlled,non-inferioritytrialwasconductedfromOctober2006throughFebruary 2008atSanFranciscoGeneralHospital(SFGH),thepublicteachinghospitaloftheCityandCountyofSanFrancisco.Atotalof 278 English- and Spanish-speaking pregnant women were randomized to receive either abbreviated or standard nurse- performed HIV test counseling at the initial prenatal visit. Patient decision making experience was compared between abbreviated versus standard HIV counseling strategies among a sampleof low-income, urban, ethnically diverse prenatal patients. The primary outcome was the decisional conflict score (DCS) using O’Connor low-literacy scale and secondary outcomesincludedsatisfactionwithtestdecision,basicHIVknowledgeandHIVtestinguptake.Weconductedanintention-to- treatanalysisof278women–134(48.2%)intheabbreviatedarm(AA)and144(51.8%)inthestandardarm(SA).Therewasno significantdifferenceintheproportionofwomenwithlowdecisionalconflict(71.6%inAAvs.76.4%inSA,p=.37),andthe observedmeandifferencebetweenthegroupsof3.88(95%CI:20.65,8.41)didnotexceedthenon-inferioritymargin.HIV testinguptakewasveryhigh(97.8%)anddidn