PRENATAL HIV COUNSELING AND TESTING RUIZ ET AL. PRENATAL HIV COUNSELING AND TESTING IN CALIFORNIA: WOMEN’S EXPERIENCES AND PROVIDERS’ PRACTICES Juan D. Ruiz, Fred Molitor, Erica Prussing, Laura Peck, and Paola Grasso Two concurrent surveys were conducted in four California counties to compare the prenatal HIV counseling and voluntary testing (C&VT) experiences of women with the self-reported practices of prenatal care providers. Participants were 850 women currently or recently receiving prenatal care and 254 providers. Although 79.9% of women reported being offered an HIV test during a prenatal visit, only 56.2% said they were told about the risks and benefits of taking an HIV test. Almost all providers (98.4%) indicated they offer an HIV test, and 76.8% reported offering counseling, to every patient. One third of the women (65.9%) knew that treatment exists for reducing the chance of prenatal transmis- sion of HIV, and 78.7% of women said they were more likely to be tested given knowledge of such therapy. Women may have underreported prenatal C&VT because providers spend insufficient time discussing related issues or because C&VT information is not presented in a way that is relevant to all patients. In 1994 the AIDS Clinical Trials Group (ACTG 076) demonstrated that zidovudine (ZDV) therapy reduced the risk of perinatal transmission of HIV by two thirds (Connor et al., 1994). In response the U.S. Public Health Service recommended rou- tine HIV counseling and voluntary testing (C&VT) for pregnant women (Centers for AIDS Education and Prevention, 14(3), 190–195, 2002 © 2002 The Guilford Press 190 Juan D. Ruiz, Laura Peck and Paola Grasso are with the California Department of Health Services, Office of AIDS, Sacramento. Fred Molitor is with ETR Associates, Sacramento, CA. Erica Prussing is with the Child and Adolescent Services Research Center, Children’s Hospital-San Diego, San Diego, CA. The authors thank the Centers for Disease Control and Prevention for providing funds for this project. They also thank the women and prenatal care providers who participated in the surveys. The authors express their appreciation to the local project coordinators and staff: Susan Black, Joyce Gertler, Beatriz Martinez, and Tazima Jakons (Alameda County); Michelle Jay, D.V.M., M.P.V.M., Ketty Mobed, Ph.D., Maria Coutee, Gwen Roedel, Yezenia Garza, and Lorena Perez (Sacramento County); Michelle Ginsberg, M.D., Steve Hart, Sandy Garcia, L.V.N., Lora Santillan, R.N., and Yolanda H. Lopez, M.P.H. (San Diego County); and Geneva Bell-Sanford, M.S.W., Elaine O Neil, Valentina Pegg, and Olga Friaz (San Joaquin County). In addition, many thanks to the following Office of AIDS colleagues who reviewed this manu- script and provided the authors with valuable comments: Vanessa Baird, Michael Montgomery, Richard Sun, Arti Parikh-Patel, Matthew Facer, Laurel Cima, and Catherine Lopez. Some of the results of this study were presented at the American Public Health Association 126th annual meeting in Washington, DC, November 1998, and the Maternal and Child Health Workshop in Atlanta, GA, December 1998. Address correspondence to Juan D. Ruiz, M.D., Dr.P.H., Office of AIDS, California Department of Health Services, 611 N. Seventh St., P.O. Box 942732, Sacramento, CA 94234-7320; E-mail: jruiz1@dhs.ca.gov.