HIV-related discrimination in abortion clinics, New York City, USA: 1988-1992.
Int Conf AIDS 1993 Jun 6-11; 9:914 (abstract no. PO-D26-4178) de Jung T, Holman S, Carrino AF, Caplan-Cotenoff S, de Leon D; NYSDOH AIDS Institute, NY.
HIV-related discrimination is a continuing social problem extending into the realm of health care delivery. To determine the extent of HIV-related discrimination against women seeking abortion services, we called the total population of abortion providers advertising in the New York City Yellow Pages in 1988, 1990, and 1992; after establishing an initial appointment for an abortion, the caller told the provider that she was HIV positive. In 1988, we found that among 33 abortion providers surveyed, 14 (42%) refused to provide services when they discovered that the client was HIV positive. In 1990, we resurveyed the original providers plus new abortion providers for a total of 51; 16 (31%) of the providers either refused an appointment or increased the fee for an abortion on learning that the caller was HIV positive. After the 1990 survey, the New York City Commission on Human Rights issued either a letter or a letter and a subpoena to 18 abortion providers believed to have discriminated on the basis of HIV status. We resurveyed the entire sample in 1992 to determine whether this intervention reduced discrimination among providers. We found that only 2 (4%) of the abortion providers discriminated in 1992; of these, only one had received a subpoena in 1990 while the other discriminated for the first time. Results of a t-test indicated that, while there was no significant difference in discrimination in 1988 and 1990, there was a significant difference between 1988 and 1992 and 1990 and 1992. Moreover, regression analysis revealed that the intervention (letter and/or subpoena) was significantly associated (p = .0001) with a provider's change in discrimination patterns from 1988 or 1990 to 1992, but was not significantly associated with a provider's no longer providing abortion services in 1992. While other unmeasured historical factors may have resulted in an increased awareness of HIV on the part of the abortion providers, our results indicate that HIV-related discrimination does occur and is potentially mitigated by active intervention.
Keywords: AEGIS, Abortion, Induced, Abortion, Spontaneous, HIV Infections, Fetal Death, HIV Seropositivity, New York City, Ambulatory Care Facilities, Data Collection, Human, Female, Pregnancy, surgery, ICA9 930606
POD264178
