Changes Sought in HIV Testing; New Approach Would Have Pregnant Women in Washington State Automatically Screened

Under a controversial proposal being considered by the Washington State Board of Health, pregnant women would automatically be tested for HIV, though they would have a chance to refuse the test. Currently, pregnant women are not tested for HIV unless they choose -- an approach known as "opt in" because the women must act in order to be tested. In the new approach being considered -- called "opt out" -- they must act in order to avoid testing.

A number of prominent national groups, including the CDC, the Gay and Lesbian Medical Association and the American College of Obstetricians and Gynecologists, have recommended more aggressive testing for the virus. Of mothers who test HIV-positive, 25 percent will pass the virus to their newborn. But if those infected mothers are identified and treated with the drug AZT, only 8 percent will transmit the virus. Last week the Governor's Advisory Council on HIV/AIDS voted 8-1 against adopting the new approach, largely because only three Washington women in four years have transmitted HIV infections to babies. The vote does not bind the state health board, which has disagreed with the council in the past.

The council is concerned that women might not be told they can refuse the test or take it anonymously. Also, some women might be afraid that refusing it would jeopardize their medical care, said the council vice chair Jeffrey Schouten. A discussion paper prepared for the council said most women think HIV testing should be routine. The health board is expected to discuss the issue at its September meeting.

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