Mandating HIV testing for moms and newborns

Early detection is key. But should the state require testing?

Published March 23, 2007 6:27PM (EDT)

There's a complicated debate raging in the Garden State over a proposal to mandate HIV testing for mothers and their newborns. The argument, of course, is that early detection and treatment of HIV is essential. The man behind the bill, Senate President Richard J. Codey, said, "For newborns this can be a lifesaving measure."

In addition to testing all newborns, the measure would "require that pregnant women be tested for HIV as early as possible in their pregnancy and again during their third trimester," reports the Associated Press. And, in fact, the Centers for Disease Control and Prevention found that treatment of an HIV positive pregnant woman reduces the transmission rate to 2 percent. (Comparatively, the transmission rate is 13 percent if the baby is only treated after birth, and 25 percent without medical intervention.)

Part of the impetus for the bill is that New Jersey has the third-highest incidence of pediatric HIV cases and fifth-highest rate of AIDS cases among women. "In a state with some of the highest HIV rates among women, this move should be a no-brainer," Codey told the AP. "The additional benefit of testing every woman is that it reduces the stigma associated with testing only those based on their risk behaviors and should, as statistics show, make women less inclined to refuse the test."

But, some feminist organizations argue that the measure impinges on women's right to privacy and making personal medical decisions without the interference of the state. "What's really needed is good counseling, preventative education and conversations with respectful medical personnel and counselors about HIV," said Leslie Wolfe, president of The Center for Women Policy Studies.

In some ways this bill seems akin to slapping a few patches on a punctured, rapids-bound river raft and crossing one's fingers. Clearly, with New Jersey's soaring HIV/AIDS rates, the first goal should be preventive education. But, on the other hand, by testing all pregnant women there's the chance to reduce the chances of HIV positive women passing the virus onto their child. There might also be some comparisons to be made to the debate over mandating the HPV vaccine; everything possible should be done to give a newborn a shot at a healthy, disease-free life, right?

But, if we start mandating HIV testing for mothers and newborns, next we'll require that all people are tested. (And that's just the start of it.) Where to draw the line?

By Tracy Clark-Flory

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