  
Two studies find Connecticut mandatory HIV screening law is a success
Last Updated: 2001-05-03 15:00:05 EDT (Reuters Health)
By M. Mary Pennell
CHICAGO (Reuters Health) - Less than 2 years after Connecticut became the first state to mandate HIV screening for pregnant women, the results of two studies presented at the American College of Obstetricians and Gynecologists indicate this law is a success.
Dr. Urania Magriples of Yale University in New Haven told Reuters Health that the new law has increased the rate of documented HIV tests at Yale's high-risk pregnancy clinic to 91%. "I was originally opposed to this law because I thought it was coercion; but it works," Dr. Magriples said. The law, which took effect October 1, 1999, requires that pregnant women are screened for HIV and if no documented HIV test is on file before delivery, the law mandates HIV testing for the newborn.
Dr. Magriples and colleagues compared the HIV testing status of 180 women who received prenatal care at the Yale clinic to the HIV status of 187 pregnant women treated at the clinic after the law was enacted. Before the law "only 38.9% of women were tested for HIV, but after the law 91% of the women were tested," she said. Women can refuse testing for themselves or their babies on religious grounds, she added.
Rather than being coercive, the law "appeals to the maternal instinct in these women to protect their babies," Dr. Magriples said. Women are told that if they are HIV-positive, they will be given antiretroviral therapy during pregnancy "so the baby will be protected against HIV."
In the second study Dr. William Cusick of the Stamford Hospital studied the effect of the law during its first 10 months of implementation. Dr. Cusick said that 2352 infants were born to 2239 women during the study period. Seven women were identified as HIV-positive and two additional cases--a husband and a child--were identified after a positive test in the pregnant woman. "Without the mandatory testing, I think we would have missed six of these nine cases," Dr. Cusick said in an interview.
"The results of our study demonstrate that the law is working exactly as intended," Dr. Cusick said. At his institution, HIV-positive pregnant women are treated with highly active antiretroviral therapy. "So far all of the children are fine and we've followed them out for 12 months now," he said.
Dr. Cusick said Connecticut is currently the only state that mandates HIV testing.
The American College of Obstetricians and the American Academy of Pediatrics issued a joint policy statement on HIV screening 2 years ago. It states that both groups "support the recommendation of the Institute of Medicine for universal HIV testing with patient notification as a routine component of prenatal care." However, an ACOG spokesperson said the statement does not endorse "mandatory testing."
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