Illinois: HIV Compromise Wins Support

An Illinois bill would make HIV testing routine for infants born to mothers who have not taken an HIV test themselves. However, the bill falls short of requiring that mothers be routinely tested, something CDC and doctors statewide believe would be an even more effective way to prevent mother-to-child HIV infection and improve the outcomes for infected mothers, as well.

The testing bill, which received overwhelming Senate approval and heads to the House this week, would require that pregnant women be counseled about HIV and offered HIV testing. That is an “opt in” policy, one CDC says does not work as well as an “opt out” rule, which makes prenatal HIV testing automatic unless a woman signs a form rejecting it. The measure is moving forward, nonetheless, supported by many doctors and civil libertarians who oppose mandatory testing. Civil libertarians are comfortable with the bill because it allows women to reject the test.

The proposal would routinely give newborns an HIV test when their mothers’ status is unknown. Those tests would be automatic unless the mother signs a form declining the test. Only New York and Connecticut have adopted mandatory newborn testing for HIV. Civil libertarians had worried a mandatory HIV test would infringe on a woman’s right to decide the treatment for her and her baby, and could drive away patients who might fear that a positive test would become public. They are satisfied with the current bill.

The American Academy of Pediatrics cites statistics that show mother-to-child HIV transmission can be prevented 99 percent of the time if the mother is tested and drugs are administered prenatally. An HIV-positive woman who waits until delivery to receive antiretroviral drugs puts her child at a 12 percent to 15 percent risk of getting the virus. A baby who tests HIV-positive and was born to a mother who never was given treatment has a 30 percent chance of getting HIV. In Illinois, 50,000 newborns are born each year to mothers whose HIV status is unknown, according to Children’s Memorial Hospital in Chicago. Of those, 150 to 200 will test positive for HIV antibodies.

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