NJ lawmakers approve HIV testing for pregnant women, newborns

Via the Associated Press (6/21):

New Jersey on Thursday moved to require both pregnant women and some newborns to be tested for HIV.

The Assembly voted 74-5 and the Senate 37-0 to approve the bill. The bill now goes to Gov. Jon S. Corzine for his consideration.

It requires all pregnant women be tested twice for HIV, once early and once late in the pregnancy, unless the mother asks not to be tested.

It also requires newborns to be tested if either the mother has tested positive or her HIV status is unknown at time of birth....

The state has about 115,000 births per year and had seven infants born with HIV in 2005.

The American Civil Liberties Union and women's groups contend the bill deprives women of authority to make medical decisions.

How helpful is it to mandate HIV testing of pregnant women?  From an ACLU factsheet:

At first blush, it might seem like there could hardly be a more compelling case for forced testing. Children's lives are at stake.  But responding to perinatal testing proposals in a thoughtful way requires a hard look at the science.  What that hard look shows is that few of the new proposals - and none that have been enacted into law - advance our ability to stem transmission to infants in a meaningful way.

Here's what the science shows.  A pregnant woman, infected with HIV, has a base-line one-in-four chance of transmitting HIV to her newborn if she takes no treatment at all.  The transmission occurs most often during delivery, because delivery is when the infant is exposed to the most blood of the mother without the protection of the umbilical barrier.  Intrauterine (pre-delivery) transmission is rare. Transmission can also occur through breastfeeding after delivery. 

When an infant is born to an HIV-positive mother, HIV-antibody tests on the newborn will always be positive because the baby has inherited the HIV antibodies of its mother.  This does not necessarily mean, however, that the infant is infected.  Not until the mother's antibodies disappear from the infant's system - which takes a few months at least - will HIV antibody tests on the baby show the baby's own status rather than the mother's.

See also HIV Testing and the Federal Ryan White Grant Program.