Mandatory Prenatal Hiv Testing Essay, Research Paper

A. Summary This particular journal researches prenatal HIV testing as it relates

to vertical transmission.

1. Randomized controlled studies involving HIV- positive pregnant women at various stages of pregnancy were monitored and evaluated in an effort to find conclusive reasoning for prenatal testing. Women of different income levels, educational and ethnic backgrounds were involved in these studies.

2. The AIDS Clinical Trials Group Study 076 as well as following

randomized controlled trials were used in order to test whether prenatal testing was an effective means of preventing the vertical transmission of the HIV virus. Quick and relatively simple tests were performed in order to first determine whether pregnant mothers were HIV- positive. If the mother then tested seropositive, antiretroviral therapy was begun in an effort to reduce the perinatal transmission of the virus. Randomized trials performed in developing countries also tested whether early detection followed by antiretroviral therapy greatly reduced viral transmission.

3. The ACTG 076 showed that in cases involving prenatal HIV testing,

where the virus was discovered in the earlier stages of pregnancy, that treatment could lower the chance of transmission from 25 % to 8 %. Furthermore, since these findings were released along with the recommendation that prenatal testing be mandatory for all pregnant women the cases of perinatally transmitted AIDS reported in the United States have been cut in half.

B. Critique AIDS Clinical Trials Group Study 076 produced evidence that

mandatory prenatal testing would be effective, but it is plausible that the study itself could have been more effective.

1. The studies performed were statistically sound and lead to seemingly

significant results. Randomized and controlled studies were performed subsequently in an effort to ensure useful results. Statistically, these methods of research produce findings that are typically more accurate than the other various approaches to research.

Likewise, the HIV test itself is basically a simple and for the most part accurate means of determining whether a pregnant mother is HIV- positive. The tests were administered to mothers that had already tested positive in order to further ensure the accuracy of the study. In this way, it appears that much time and effort was put forth in order to find conclusive reasoning either proving or disproving the theory that prenatal HIV testing should be mandatory.

On the other hand, in order to develop policies that would make prenatal screening mandatory there are two sides to consider; pregnant women who are HIV- positive and pregnant women who do not carry the virus. In this way, the study lacks in including women who must be tested for seemingly no reason. It fails to mention if any undue hardships must be placed upon women who are HIV- negative.

2. Because HIV can be a treatable disease the findings from this study are as

most would expect them to be. Early detection leads to an increased likelihood of preventing the viral transmission of the disease. The findings themselves are quite impressive also. If at anytime the spread of a disease can be decreased by nearly 50 % as long as it is detected and treated in a timely fashion, then it is easy to assume that those measures would be widely accepted.

However, for some it is an issue of privacy or civil rights. For others they may avoid prenatal care because they fear HIV testing or resent the mandatory policy. These women would lose the opportunity to receive benefit from antiretroviral therapy if they were infected, and, more important, they would lose the benefit of prenatal care regardless of whether they were infected with HIV. Mandatory testing might deter the women who are the most likely to be infected with HIV from receiving prenatal care. Furthermore, because the odds of the baby actually being born with AIDS are sometimes low, some mothers do not believe it is worth the drama if the baby may be born seronegative.

Issues involving pregnancy are continually made more complicated because of opposing views on the decisions made regarding the baby’s health. Many uneducated mothers do not realize or fully understand the consequences of their decisions on the baby’s livelihood. These same mothers also feel that they, not their doctors should make those decisions because after all, it is their baby.

C. Argue Before writing this paper I had an idea of what my feelings on the issue were, but I attempted to begin it without bias. As the paper progressed it only reaffirmed my original stance, that prenatal HIV testing should be mandatory.

Women, concerned about the health of their children, will not be opposed to mandatory HIV testing and care given appropriate counseling and education. There is almost no argument that a mother ever should risk the life of her child because she believes a simple ten-minute test is slightly unjust or unfair or that she is being inconvenienced. Her child’s health should always come before things of that nature. Also, the tests are always in the best interest of the child, it is not as if they are meant to alienate or be troublesome to the mother.

Furthermore, mandatory testing for AIDS identifies pregnant women who are unaware they are carrying the disease. Evidence that early detection reduces the chances for transmission are conclusive in nearly every study on the matter. Therefore women should be offered HIV-testing prior to or early in pregnancy so that they can make decisions regarding their own health as well as decisions about reproduction. Also, after an HIV test has been performed on a pregnant mother there is only a limited window of time where antiretroviral therapy will prove most effective. Bercause of this, if testing was voluntary a mother may put if off until it has already become too late to be effective. Along those lines, if only one child in a million can be saved from contracting AIDS because of a mother who wouldn’t normally have been tested was forced to, it seems as if it was all still worth it.

Transmission of HIV from a mother to her infant is the leading cause of HIV infection in children. Prenatal testing offers a better opportunity to prevent the spread of HIV infection from mother to child than screening performed after the baby is born. This is because babies born to HIV- positive mothers who are treated prenatally and during delivery have an estimated 8 % chance of contracting the virus. A baby treated after delivery may benefit from the drug, but will likely remain infected.

Although the positives of mandatory testing appear quite evident in this journal, the benefits of mandatory HIV testing must be substantial and must be continually demonstrated before such a policy is implemented. The consequences must be considered and studied at great length in order to determine whether what I see as a good idea really is. After all, we are making a decision on behalf of an unborn child, a decision that could profoundly affect their entire life.