Prevention Of Hiv Transmittance To Babies

Prevention of HIV Transmittance to Babies

Last year, it was cause for celebration. The cause of celebration was for the results that several clinical trials of zidovudine cut the risk for mother to child transmission of human immune deficiency virus (HIV) by two thirds.

Although, this year, it is the basis for new federal recommendations that all pregnant women should receive HIV testing and counseling. But, these findings have been cause of protests by several activist groups. Activists fear that conservative legislators and policy makers will use the clinical data to justify mandatory testing and treatment for pregnant women.

During the latter part of February, the United States Public Health Services published guidelines for HIV pregnant women in the Federal Register. Which coincidentally was published on the same day as the National Conference in

Washington, DC for "HIV infection in women: Setting a New Agenda." The conference included activists, physicians and HIV positive women who used the meeting as a forum to voice their concerns about how best to balance women's own medical needs with those of their infants. Other concerns of activists that were voiced were that they don't want laws, policies or medical care imposed on women merely as "vectors" who may transmit HIV to their infants.

The new guidelines recommend that all pregnant women should receive HIV counseling and testing. These guidelines are aimed at helping pregnant women know their HIV status early so that medical care, including zidovudine (Retrovir, known as AZT, Burroughs Welcome Co., Research Triangle Park, NC), can be made available. The new guidelines also reiterate previous federal health advisories that say counseling should precede HIV testing. Physicians and other health professionals who counsel women should be well informed about the complex issues that face HIV infected pregnant women, according to the guidelines. This information should include about all of their reproductive options. Women should also be advised that in order to help reduce prenatal HIV transmissions

HIV infected women in the United States should not breast feed their infants.

The guidelines further states that all HIV testing should be voluntary for women and their infants. Also, all decisions about AZT use should be made by the HIV infected pregnant woman in a non coercive atmosphere...

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...say that initiative like those in Illinois and New

York are likely to crop up in more states. To counter pro-mandatory testing movements, activists have urged federal health officials to strengthen language in the guidelines before they are finalized so that the document won't be construed as supportive of mandatory testing.

Mandatory testing has been controversial since the AIDS epidemic began.

Opponents contend that is violates civil rights, results in discrimination and may drive some people away from receiving the medical care they need. Therefore, without a stronger message in support of voluntary testing the guidelines may become a way to discriminate against pregnant women who are HIV positive.

Bibliography

Rogers, Martha, Simonds, R.J.; March 15, 1996; Preventing Prenatal HIV

Infection "How Far Have We Come?"; Journal of the American Medical Association

Volume 19; Page 1514

Voelker, Rebecca; April 5, 1996; US Public Health Service Recommends Counseling and HIV Testing For All Pregnant Women; Journal of the American Medical

Association; Volume 19; page 977

Wolfe, Maxine Ph.D.; October 1, 1996; Mothers To Infant HIV Transmission 076

Update; Women Alive; page 6