We say NO! As women working as AIDS activists, healthcare providers in HIV/AIDS and as child advocates we felt it was important to speak out to this issue. While no one wants to see an infant suffer unknowingly until PCP is diagnosed when prophylaxis may have prevented it, we must realize that any mandatory testing sets up a dangerous precedent.
Society and Discrimination
Many of us working in AIDS realized early on that mandatory testing would drive the disease underground, increasing infections and delaying treatment.
As a society we ignored its early beginnings believing it only affected those immoral homosexuals and drug addicts.
No one viewed this for what it is, a virus which knows no boundaries. Now, 15 years later HIV has infected women, infants and young teens in tremendous numbers, and still society has not embraced AIDS without judgment or discrimination.
Society has been and still is short sighted, letting hate and disdain set the agenda. Is it no wonder that we, The Lesbian and Gay Communities and our supporters came together to advocate for care and antidiscrimination laws!
An Assumption of Blame
Now it is we who cannot be short sighted into believing mandatory testing is okay for newborns.
We know when you test an infant for HIV at birth you are also testing for the mother's antibodies without her consent. We also know that 75% of these newborns will clear these antibodies and that the remainder will have true HIV infection. So the majority of the mandatory testing is aimed, by default, at the woman. So why take on this dangerous issue? There appears to be an assumption of blame towards women that they will not do what is best for their babies. Yet, most of the women we see in our practice, neglect their own health to care for their children and partners. Furthermore, several studies, including from the Centers for Disease Control report that 96-98% of pregnant women who were counseled regarding testing for HIV agreed to take the test.
Does Mandatory Testing Save the Lives of Newborns?
Unfortunately, it does not. At best, it may help extend life by early prophylaxis treatment. What can save lives is a serious effort on our part to advocate for prevention from infection in the first place. This, we unfortunately, have not been very successful at, as we continue to see increasing infections in all groups of people.
We must be willing to take on this public health crisis in a careful and responsible way, without adding fuel to the flames of blame and intolerance to the already infected...
Until condoms, dental dams and clean needles are as common as cookies and milk, until it is socially shocking to have unsafe sex, until we realize sex is something we have to talk about at an early age and in our schools, until we have more drug treatment programs, until there is a medical cure, the only way to save ourselves and future generations is prevention.
Personally, we would love to see everyone voluntarily test for HIV on a regular basis. We believe, early medical intervention works to extend life once HIV infected and also helps decrease further infection rates through counseling and education.
We also believe that the people who support mandatory testing do so because they care deeply, as we do, about protecting our newborns. And yes, this issue tears at the hearts of all of us.
Take Another Look
We implore the AIDS activists, pediatricians, child advocates and others, who support mandatory HIV testing of newborns to look again at this issue, to invite dialogue within our communities. We must be willing to take a stand to develop and implement creative prevention strategies. We must be willing to take on this public health crisis in a careful and responsible way, without adding fuel to the flames of blame and intolerance at the already infected, especially women who will be the target of this action.
Mandatory testing is not the answer, prevention is. Only then can we say that we have truly saved lives.
Mary L. Adair, PA-C, Clinical Practice in HIV/AIDS, Los Angeles. Former Board Chair, AIDS Healthcare Foundation. Former Board Member, National Child Rights Alliance.
Pamela L. Burian, PA-C Clinical Practice, HIV/AIDS, Los Angeles Site Coordinator, Womens HIV Interagency Study.