HIV Testing: Pregnant Women and Newborns, HIV Law Project (2009)

In an effort to influence the national debate regarding the testing of pregnant women and newborns for HIV, the HIV Law Project drafted this report to explain why the current trend toward opt-out testing is neither effective for preventing mother-to-child transmission (MTCT) of HIV, nor useful for maintaining women in health care. According to the report, “the strategy for preventing mother-to-child transmission…cannot focus solely on testing and treatment of pregnant women and newborns.” The report points out that, without any medical intervention, the chance of a woman transmitting HIV to her child during pregnancy and childbirth is only 25%. Although that percentage may be lowered with the use of antiretroviral drugs during pregnancy and at labor and delivery, the decision to take those drugs must be made by the woman, in consultation with her medical provider. The report also explains how nearly perfect HIV testing rates may be achieved during pregnancy with a voluntary, opt-in approach. Coercive testing, for either women or newborns, only serves to alienate women from their providers and decrease their investment in their own medical care. This, according to the report, brings us no closer to the goal of reducing MTCT. The report offers three specific recommendations to help reduce MTCT while protecting the rights of women: (1) increase voluntary (opt-in) testing rates among pregnant women by implementing HIV counseling and universal offer of testing, (2) implement a comprehensive women’s health care model that includes universal offer of testing and an opt-in testing model at regular gynecological visits, and (3) expand access to prenatal care for all women.