Illinois House To Consider Bill To Mandate HIV Counseling for Pregnant Women, Require Testing for Infants

The Illinois House of Representatives next week is scheduled to consider a compromise bill (SB 263) that would require health care workers to provide voluntary HIV counseling and testing to pregnant women and would mandate HIV testing for infants born to women whose HIV status is unknown, the Chicago Tribune reports. The bill, which has received "overwhelming" Senate approval, would require that any pregnant woman who decides to be tested sign an informed consent form before undergoing the test, a system otherwise known as "opt-in" testing. However, under the measure, infants born to women whose HIV status is not known would automatically be tested for the virus, unless the mother signed a form to "opt-out" of the infant testing (Kapos, Chicago Tribune, 4/20). The CDC last week in the April 18 issue of Morbidity and Mortality Weekly Report outlined its new HIV/AIDS prevention strategy, which includes recommendations for opt-out testing for pregnant women. According to the CDC, opt-in HIV testing systems do not work as well as opt-out systems that do not ask for specific consent (Kaiser Daily HIV/AIDS Report, 4/17).

Reaction
"It's a weak bill," Robert Murphy, director of clinical research for HIV/AIDS at Northwestern University's Feinberg School of Medicine, said, adding, "It goes against the best public health measures that are recommended." However, other AIDS advocates supported the measure because it includes counseling and allows women to reject the test. "Studies show that when you counsel women, they agree to be tested," Ann Fisher, executive director of the AIDS Legal Council, said. She added, "The problem is when doctors look at a pregnant woman and make an assumption that she is not at risk and so they don't bring up the messy topic of HIV." Without treatment for HIV-positive women or their infants, newborns have about a 30% chance of contracting the virus. However, if a woman tests HIV-positive and receives treatment during her pregnancy and delivery, and the infant is given medications following birth, HIV transmission can be prevented about 99% of the time, according to the American Academy of Pediatrics and the American College of Obstetricians and Gynecologists. According to the Children's Memorial Hospital, each year in Illinois 50,000 infants are born to women whose HIV status is unknown; of those, 150 to 200 will test positive for HIV antibodies (Chicago Tribune, 4/20).