THE FAILURE OF THE federal government and the medical establishment to forthrightly address the increase in HIV in women has become the focus of much debate.
A recent National Institutes of Health research trial showed that pregnant women who are HIV-infected and take the drug AZT in the 14th to 34th week of pregnancy may reduce their risk of transmitting HIV to their unborn child. This encouraging news has heightened calls for efforts to ensure that more be done to reduce HIV infection in women and infants.Unfortunately, several politicians, capitalizing on public confusion about the complex issues regarding HIV pregnant women and newborns, have put forth misguided and inappropriate legislative proposals.
For example, one measure proposes to mandate HIV testing of all newborns. Such a proposal will do nothing to help mothers or infants with HIV.
Testing newborns will not help mothers or babies. In fact, a positive test result does not necessarily mean a newborn is infected. Because newborns have their mothers' antibodies, a positive test result means that the mother is infected. While most newborns whose mothers are infected will initially test positive, most are not infected themselves.
Even if we know the results of a newborn's HIV-antibody test, this information will not prevent a baby from getting HIV disease. Once the baby is born it is too late for the prenatal AZT therapy that could reduce the chances that the infant would be infected in the first place.
Testing newborns alone does nothing to decrease HIV infection or ensure vital care or services for women and infants. Such widespread testing will require enormous resources with little real benefits. Resources should be committed to counseling and pre- and post-natal services for women and infants, so that life-saving and life-extending care is given.
That is the more sensible approach, and the one recently adopted by the Senate, where Sens. Nancy Kassebaum, R-Kan., and Ted Kennedy, D-Mass., added a provision to the Ryan White CARE Act that requires the 11 states where 80 percent of the cases of perinatal transmission occur to implement guidelines ensuring that all pregnant women are counseled and offered testing for HIV.
This approach helps reduce transmission and ensure that mothers and their health-care providers can plan for the care and treatment of their babies.
Finally, it's time to reject the 30-second sound bite approaches cherished by politicians like Rep. Gary Ackerman and start adopting real measures to stop the spread of AIDS in women and infants.
The American College of Obstetricians and Gynecologists, the American Academy of Pediatrics, the Pediatric AIDS Foundation and others agree that mandatory HIV testing is the wrong approach.
What our country really needs is better prevention and education about HIV/
AIDS, targeted to women; we need better access to prenatal care and counseling for all women; and we need better care for HIV-infected women with children. And we need them now.