Summaries of health policy coverage from major news organizations
Indiana Bill Seeks to Add HIV Testing to Standard Prenatal Screenings
Indiana state Sen. Patricia Miller (R) is sponsoring a bill that would add an HIV test to the standard set of prenatal screenings performed on women, the Indianapolis Star reports. Current law requires that doctors counsel pregnant women about the test and offer the test, and allows a doctor to test an infant without parental consent if the doctor believes it is "medically necessary." Dr. Martin Kleiman, director of pediatric infectious diseases at the Indiana University School of Medicine, called the current law "very discriminatory" and based on "subjective criteria," adding that doctors are "far less inclined" to test middle class married women. The new proposal would require doctors to perform an HIV test on every pregnant woman, "unless the woman refuses," and would require testing infants whose mothers were not tested. Opponents say the current law is effective and the proposal would weaken a woman's control over her medical care, but Miller and her supporters "are quick to point out" that the latest bill, the third of its kind Miller has introduced, is not mandatory testing. Six states -- Arkansas, Connecticut, Florida, Michigan, New York and Tennessee -- have laws similar to the bill Miller has proposed. Supporters of the bill say the law would protect more infants from HIV infection because caesarean section delivery and the administration of AZT to the woman and newborn, both of which reduce vertical transmission risk, are only possible with early awareness. Formula feeding after birth also reduces transmission risk. Kleiman estimates that if pregnant women in the United States were tested and treated for HIV infection, 400 babies a year nationwide could be "spared" from infection. But Dr. Judith Ganser, director of maternal/child health for the Indiana State Department of Health, said that the current laws are "effective," as only two known cases of transmission were reported in 1998, the most recent year for which figures are available. Last year officials estimated that the program would cost the state about $250,000 a year to cover tests for pregnant women enrolled in Medicaid and state employees (Barton, Indianapolis Star, 1/23).
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