Trends in HIV Prenatal Testing among Commercially Insured Pregnant Women in the United States, 2011-2022.

BACKGROUND: In 2016, prenatal HIV testing in the United States was integrated into a new obstetric panel with other recommended tests. We examined prenatal screening rates for HIV and the impact of the introduction of the new obstetric panel on HIV testing rates among commercially insured pregnant women. METHODS: We used MerativeTM MarketScan® Research Databases to identify pregnant women aged 15-49 years and calculated annual rates of testing with the new obstetric panel (80081), old obstetric panel (80055), individual prenatal laboratories plus HIV tests, and total HIV testing in the United States from 2011-2022. We used generalized multivariable Poisson regression model to explore the factors associated with the utilization of the new panel code and binomial logistic regression-based inverse probability weighting to estimate the impact of the new obstetric panel code on HIV testing rates. RESULTS: Overall HIV testing among pregnant women increased from 75.3% in 2011 to 90.0% in 2022. The use of the new panel rose from 10.1% in 2016 to 32.1% in 2017. The introduction of panel 80081 led to HIV screening in approximately an additional 4.9% of all pregnancies that otherwise would not have been tested. CONCLUSION: Among pregnant women with private insurance in the United States, the implementation of obstetric panel 80081 significantly increased HIV testing since its introduction in 2016, which is now at 90% of pregnancies. However, there remain some missed opportunities for prevention and care. Bundling prenatal tests for ease of ordering represents an effective approach to reach public health goals.