HIV Testing for Pregnant Women & Newborns
Len Deo, President, NJ Family Policy Council,
and former member of the NJ Governor’s Council on AIDS 1998-2002.

On May 10th, NJ Senate President Richard Codey introduced legislation which would require all pregnant women and newborns to be tested for HIV. The legislation should be supported because similar laws have significantly reduced the number of HIV-infected infants and enables women who may have HIV to be diagnosed and treated sooner rather than later – when it may be too late.

The NJ Family Policy Council has had its differences with some in the AIDS “community” in the past, in particular with regard to so-called “harm reduction” policies like needle exchanges which are not scientifically proven to reduce the spread of HIV. However, with regard to improving state law to ensure that those living with HIV have early access to treatment and that the most innocent among us are given hope and a future, we agree. Today we have the knowledge and the treatment resources to provide hope to anyone who is living with HIV/AIDS, but we must remove the fear-based barriers to testing which have served as deterrents to early diagnosis and treatment. As many as 45 percent of persons testing positive for HIV received their first positive test result less than a year before AIDS was diagnosed. With an average of 10 years between HIV infection and an AIDS diagnosis, this suggests that people are living with HIV for many years before they are aware of their infection and may be unknowingly spreading it to others.

Mandatory “Baby-AIDS” laws in NY and Connecticut have had great success. New York passed a law requiring HIV testing of newborns which was implemented in 1997. The number of HIV infected infants has dropped from more than 500 a year (est. rate of transmission 20-30%) in the early 1990s to 16 in 2004 (2.8%). The proportion of all pregnant women being aware of their HIV status at delivery increased from 64 percent in 1990 to 95 percent in 2004.

Connecticut passed a similar law in 1999 requiring that newborns be tested for HIV if their mothers’ HIV status was unknown. Prior to the law only 28 percent of pregnant women were documented as being tested for HIV, while during the same time period prenatal testing rates for other diseases were over 90 percent. This demonstrates how the previously existing counseling regulations for HIV testing discouraged testing. After the law was in place the number of pregnant women being tested for HIV jumped to 90 percent. In addition, Reuters Health reported in February that according to preliminary data, more effective HIV treatments (plus early detection laws) may be related to some women’s decisions not to have abortions. In Connecticut during the year the law was passed, 70 HIV-exposed newborns were born with 5 infants becoming infected with the virus. From 1999-2004 however, over 300 HIV-exposed infants were born with only five infants becoming infected. In fact, from 2002-2004 there has been no babies born with HIV.

In New Jersey the total cumulative pediatric AIDS cases through 2005, were 772 cases, the third highest in the nation behind New York and Florida, and 409 pediatric HIV cases, the second highest in the nation behind New York, according to the Kaiser Foundation. Yet current New Jersey law only requires providers to “offer” HIV testing to pregnant women. As explained above, and documented by the CDC’s September 2006 MMWR report, this method is ineffective because most women are not tested under voluntary parameters.

Many medical/scientific authorities recommend routine newborn HIV screening when a mother’s status is unknown including the American Academy of Pediatrics, American College of Obstetrics and Gynecology, the Institute of Medicine, the President’s Advisory Council on HIV/AIDS and the CDC. If we are to end this epidemic, it is essential to make every effort to promote early diagnosis and treatment for those who are infected. We must also empower both those who are infected and those who are not infected to prevent HIV from taking another life. We congratulate Senate President Richard Codey for promoting such an important piece of legislation.

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