Legal Barriers to Implementing Recommendations for Universal, Routine Prenatal HIV Testing

• Published in: The Journal of law, medicine & ethics Vol. 32; no. 1; pp. 137 - 147
• Main Authors: Wolf, Leslie E., Lo, Bernard, Gostin, Lawrence O.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 22.03.2004; SAGE Publications; Sage Publications, Inc; Cambridge University Press
• Subjects: AIDS Serodiagnosis - legislation & jurisprudence; Anti-HIV agents; Antiviral agents; Babies; Childbirth & labor; Confidentiality - legislation & jurisprudence; Consent; Constraints; Counseling; Diagnosis; Disclosure - legislation & jurisprudence; Disease control; Drug therapy; Ethics; Female; Government regulation; Gynecology; HIV; HIV infection in children; HIV Infections - diagnosis; HIV Infections - prevention & control; HIV testing; HIV tests; Human immunodeficiency virus; Humans; Informed Consent - legislation & jurisprudence; Laws, regulations and rules; Mass Screening - legislation & jurisprudence; Mass Screening - organization & administration; Medical tests; Obstetrics; Pediatric HIV infections; Practice Guidelines as Topic - standards; Pregnancy; Pregnant women; Prenatal care; Prenatal Diagnosis; Prevention; Prophylaxis; Public health; State Government; State laws; United States; Womens health; United States; United States > US; Empirical Approach; Health Care and Public Health; Institute of Medicine; Legal Approach; Genetics and Reproduction
• ISSN: 1073-1105; 1748-720X
• DOI: 10.1111/j.1748-720X.2004.tb00459.x

Administraation of antiretroviral therapy to women during pregnancy, labor and delivery, and to infants postnatally can dramatidy reduce mother-to- child HIV transmission (MTCT). However, pregnant women need to know that they are HIV-infected to take advantage of antiretroviral therapy, and many women do not know their HIV status. One-half of HIV-infected infants in the United States were bornto women who had not been tested for HIV or for whom the time of testing was not known. Although fewer than 400infants are infected perinatally in the United States each year, that number could be reduced even further through policies aimed at HIV testing during pregnancy. The reasons toadopt such a policy are strong: the pathophysiology of perinatal transmission is clear, prophylaxis is effective and safe, and the intended beneficiaries of the intervention - babies - cannot protect themselves.