NJ to require HIV Testing on all Moms and Newborns

[Polly]

http://news.yahoo.com/s/ap/20070323/ap_on_he_me/mandatory_hiv_testing

[Danielle]

I think it's a fantastic idea! With HIV, the sooner you know, the better the prognosis, especially with pregnant women passing the virus to their babies. I can't imagine anyone thinking this isn't a good idea... it will potentially save thousands of babies lives.

[Lori]

I think it's a good idea, too. Women would have the option of opting out of the testing, if they did so in writing, so it wouldn't be forcing a test on anyone who really didn't want it, but it would make sure that it was a routine part of prenatal and infant care, which I think is a good thing.

[Jennee]

i was asked if i wanted the test when i had my prenatal blood work done and i decided there was no reason not to, i was getting stuck with a needle anyway.
all my tests were negative.

[Kristi]

I agree that it is a good idea. Though not if you can't opt out. I think you should be able to say that you don't want to be tested but I think it should be offered to everyone in all states after you have had a baby.

[Beka]

we get asked here if we want screening for all std's and blood-transmitted diseases as well when we have our first set of blood work done, i have it done each time as i know the result already (and if it ever changed David would be losing testicles... with a blunt spoon ) and i have very little blood work done in pg so i am happy to go along with it and keep the hospital happy.

I do think it's a good thing- especially as so few people are std checked before they begin sleeping without barrier contraception with their long term partner (In all honesty how many of us were? I had a very limited sexual past pre-David, only slept with 1 person and been careful, David was tested as part of his drug rehab thingy he was going through- we're probably the only couple i know who had std testing prior to having unprotected sex/non-barrier contraception sex) and if a partner has an std having been with them for X months before dropping condoms isn't going to take the std away.

[gr8mommy]

I live in NJ, and would be disappointed if there were not an opt-out option. I would not want to pay for a test that I know, for myself, would be negative.

[elin]

Yes, that's the problem with the US health care system. They tell us we have to have all these things, but we have to pay for it even if we're sure we don't need it. If we had national health care and all this were covered, it would go down a bit easier. Does all insurance cover HIV testing? Some insurance is soooo skimpy on what it cover, so hopefully the bill requires insurance coverage as well.

[Beka]

I think i recall discussing this on another board a while back actually (i am a post whore- i get around a fair few boards LOL) and i also think another issue raised (along with the cost one) is some insurers would raise the cost of your coverage if they were made aware you had had HIV testing done (even when negative) as they saw it as an indication you were living wrecklessly?

[gr8mommy]

I don't know if it is covered on my policy or not, but even if it is, why should the insurance company have to pay if the test is unnecessary? Just one of the many reasons why I think an opt-out should be there.

[Jessica]

I agree that it is a good idea. Though not if you can't opt out. I think you should be able to say that you don't want to be tested but I think it should be offered to everyone in all states after you have had a baby.

ITA with Kristi. It's a great idea to offer it, I just have a hard time hearing the word "required" when it comes to ones personal life and the government. I've been offered the test when pregnant, and because I was raped at 17 I always said yes to it (since HIV can lie dormant for years upon years, having the test always seemed like a good idea.)

[Danielle]

I guess I have a hard time understanding how anyone can feel totally "safe". Even if you've only been with 1 person, maybe your partner has been with others and, as Jess said, the virus can stay dormant so even if they/you were tested at one time, it doesn't mean you're 100% safe. Maybe if you and your SO were only ever with each other... but even then, what about IV drug use, blood transfusions etc...

That being said, I can't imagine that if it was required for EVERYONE, the insurance companies could possibly discriminate on that basis. I would also hope it would be covered for everyone if it as required.

[Lori]

Danielle, that's how I feel about it. I can understanding thinking that your risk of HIV infection is small enough that it's not worth the test, but unless you're following your partner around 24/7, you can't know for 100% certain that they're not engaging in any high risk behavior.

I see the benefit of requiring the test being that getting testing wouldn't be left to the discretion of the doctor or the patient. If an HIV test were required the way that the triple-screen or a blood-sugar test are, then it would just be a routine part of prenatal care. Doctors have the same biases as anybody else, and it's very possible that a doctor could look at someone and think, 'Well, she seems like a nice, respectable woman, so there's no reason to test her for HIV,' when that woman might be an IV drug user, or sleeping around, or have a partner who's cheating, or any number of things. And because there's still so much stigma around HIV, the woman might be reluctant to ask for an HIV test, even if she knows or thinks she may be at risk, because she doesn't want her asking to change the kind of care she would get. I don't think it's unrealistic for someone to think that, if they were to ask for an HIV test, certain health care providers would make assumptions about them which could quite possibly change the kind of care they get.

So making the test required would just make it a routine part of prenatal care, like the triple screen is. In that sense I would think it's only positive, although I do think that measures would have to be taken to make sure that the information gathered from the test wasn't used in any way against the woman or the infant.

[gr8mommy]

The triple-screen isn't mandated here, I was given the option.

unless you're following your partner around 24/7, you can't know for 100% certain that they're not engaging in any high risk behavior.


I disagree.

[Desirae]

I think it should be offered. I've never even been asked if I wanted it.;) I don't think it should be mandatory though as it's a very expensive test from what I understand.

[wendygrace]

I'm ok with offering but I do have issues with anything mandated by the gov't. But then again, everything has loopholes. I just don't like that they don't tell you that you have the right to say "NO" to any testing or vaccine or whatnot. Heck, even the blood screen is mandatory, doctors just treat it as such. I nearly opted out but my midwives and I worked around my issues regarding it (I took natural sugars vs artificial sugars in the drink they offer) and we opted out of the triple screen as well. But then again, we don't vaccinate either. ;)

[Lori]

The triple-screen isn't mandated here, I was given the option.

You'd have an option for this, too, but if you had to sign something saying you didn't want the triple-screen, then it is mandated. I opted out of the triple screen, but it is a required test in MI. I had to sign a form saying that I was waiving the test.

AFAIK, mandating tests can never mean that everyone MUST have them. You can't do that, because patients are free to make their own medical decisions. What you can do is make it required for all doctors to do a test unless the patient gives their express consent not to. That's what this would be. The requirement, in practice, if it's like other medical requirements, would be on the side of the doctor, who would be required to do it unless the patient asked to not have it done, rather than on the side of the patient, who couldn't be forced by the state to undergo any medical test or procedure.

Vaccines are required/mandated, but families are able to send their kids to school without them, by submitting a form or letter. It's all a matter of what is going to be taken as the routine practice. If HIV tests were mandated, they'd become a routine part of prenatal care, but like any other routine part of prenatal care, patients would be free to opt out of them.

[Veronica]

It is standard here that HIV and std checks are done with the first lot of blood work.
Though we do have a different health care system to the USA.

[Desirae]

Lori, I didn't realize that it was mandated. Iassumed that all tests were with Aidna but didn't need to sign anything when I said no with Colin (over the triple screen).. it must be different state to state...

[gr8mommy]

You'd have an option for this, too, but if you had to sign something saying you didn't want the triple-screen, then it is mandated. I opted out of the triple screen, but it is a required test in MI. I had to sign a form saying that I was waiving the test.

.

I opted not to take it with my third baby, and did not have to sign anything.

[Beka]

opting out of the triple test in England (which we have always done) the MW just has to sign to say she has fully explained the test to you, provided information on it and is happy you are aware of what you are declining and the implications of that.

[Lori]

I had the same situation as Beka. I had to sign a form that said what the test was and that I was opting not to take it, and then my np had to sign it. There was no pressure or coercion to take it at all.

The HIV test, according to the article, would also give people the option to not take it. I'm assuming it would be a similar situation, where you and your doctor just had to sign something.

[AdinaVerbena]

I'm guessing the forms that some people sign when they opt out are in order to protect the doctor from lawsuits if something goes wrong, not really because the test is actually required (as in you are legally required to do it or you go to jail/get fined).

[Lori]

I'm guessing the forms that some people sign when they opt out are in order to protect the doctor from lawsuits if something goes wrong, not really because the test is actually required (as in you are legally required to do it or you go to jail/get fined).

That's a good point. But, I'm still not sure that any medical test can ever be required. You can't go to jail or be fined for not taking a medical test, you'd just be acting, in an extreme case, against medical advice. There are also options with even required medical tests, and in this case there would be, too.