The issue of AIDS has become an endless battle and finding a cure is the only way to win. Millions of dollars have been put towards research and experimentation but nothing substantial has been found. Other forms of prevention and protection are now being instituted in order to slow down the spread of the disease until it can be stopped. Mandatory HIV testing has become a major issue with many different opinions and debates between doctors, parents, politicians and actual AIDS sufferers who are directly involved. However I personally believe that strict mandatory testing is not the answer and other means of voluntary action needs to be explored.
The most recent and most contraversial argument is whether or not mothers should have themselves tested before giving birth. In 1993 it was estimated that 8000 pregnant women had the AIDS virus and 2000 of their newborns were infected as well. This proportion has steadily increased from 6% in 1982 to 20% in 1995 (Yogev 13:6). This new concern along with a recent discovery concerning AZT led the American Medical Association to endorse HIV testing for all pregnant mothers in 1996 as well as anonymous testing of newborns. "The use of AZT during pregnancy, labor, and early in the life of the newborn demonstrates a 2/3 reduction in the rate of HIV transmission from mother to child" (Yogev 13:6). The discovery of the new effects of AZT puts on more pressure to make the tests mandatory however many advocates for AIDS patients oppose this because of its breach of privacy rights for the mother and child. There are also delegates of the house of Representatives as well as many medical professionals who fear that if this new mandatory testing policy is enforced, many women wonít seek medical help at all during pregnancy.
There are two major arguments in favor of maintaining voluntary testing. The first being protection of the motherís right to privacy. If a newborn is automatically tested positive after birth, and the results are disclosed to the mother it is indirectly her result as well. If the mother had not consented to an HIV test for herself prior to the birth she would be forced to know her status and her childís anyway. "Ö a positive result in a newborn means the mother is also infected, identifying the infants would impose HIV testing on the mother without prior consent" (Navarro B:5). It is understandable that it would be most productive for the mother to know about herself and child as soon as possible in order to get better treatment but it is still the motherís decision.
The second argument in favor of voluntary testing is that of making an informed decision. If and HIV test is automatically given and the result is positive a mother might not know how to handle the situation. Many political and medical organizations are putting emphasis on pre and post natal care along with counseling for the mother that explains the dangers of AIDS as well as the prevention methods. By informing the pregnant mother that the drug AZT could significantly reduce transmission often leads to her consent. By allowing the mother the right to refuse (although in most cases a minimal number do) it prevents her from fearing or not trusting further care for herself and her child. "Therefore we imply that the test is strongly recommended and will be done unless the patient signs a refusal form. Such an approach will result in the largest number of pregnant women being tested and potentially the largest number of babies who escape HIV infection" (Yogev 13:6).
In conclusion I believe that the only sure answer at this time is
education. We need to inform everyone, not just pregnant women, of the
dangers of the AIDS virus so prevention and protection methods can be
instilled and utilized effectively. By giving the mother proper
counseling through doctors, pamphlets, videotapes, etc. it can help her to
make an informed, comfortable decision to help herself and her child in
the best ways possible.
This paper was prepared in 1997 for a colloquium facilitated by Stephen Wright, instructor for the Advocates for Children program, part of the College Park Scholars community at the University of Maryland, College Park.