Saving Babies

Sunday, December 30, 2007

THE STATE of New Jersey has become the first in the nation to require all expectant mothers and some newborns to be tested for HIV, the virus that causes AIDS. Moms-to-be who don't want to be tested can opt out. Considering that the Centers for Disease Control and Prevention estimate that such testing, in combination with other practices, can reduce mother-to-child HIV transmission to less than 2 percent, it's hard to imagine anyone opting out.

Connecticut, Illinois and New York mandate HIV testing of newborns. Arkansas, Michigan, Tennessee and Texas require testing of pregnant women, unless they object. When New Jersey's law goes into effect in six months, HIV testing and treatment for both the pregnant woman and the newborn will become a part of routine care. How far we've come when such a law can go on the books without the hysteria, rancor and fear that informed the nation's initial response to the AIDS epidemic.

All pregnant women who consent would have to be tested as early as possible and then again in the third trimester. The new mandate also requires that babies born to mothers who are HIV-positive or whose status is not known at the time of birth be tested. Doctors and medical workers will have to provide a host of HIV-AIDS information to the patient, including treatment options and how treatment can reduce the possibility of transmission of the virus during childbirth. These requirements track guidelines issued by the CDC that are being followed voluntarily by 29 states and the District of Columbia.

The District's annual HIV-AIDS report issued last month reported that between 2001 and 2006, there were 56 children under age 13 who were diagnosed with HIV or AIDS. That's a tragedy since it was known then that anti-retroviral treatment of an HIV-positive mother increases the likelihood that her child will be able to grow up free of the virus.

Mayor Adrian M. Fenty has committed his administration to eliminating by 2009 mother-to-child transmission of the disease with no cure. Shannon L. Hader, the District's HIV-AIDS administrator, is confident that goal can be reached without following New Jersey's lead. She said routine HIV testing is already being implemented in the city's six hospitals and one birthing center. A coordinator soon will be hired to manage it all. In little more than a year, we'll know if Mr. Fenty made the right call.

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