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New Jersey First State to Require HIV Testing for Mom & Baby
  New Jersey Requires H.I.V. Test in Pregnancy
NY Times
December 27, 2007
TRENTON - An H.I.V. test is about to become as routine as an ultrasound for pregnant women in New Jersey.
Under a bill signed into law on Wednesday, all pregnant women in the state will be tested for the virus as part of their prenatal care unless they object. The law also requires testing for newborns if the H.I.V. status of the mother is unknown.
The new testing procedures are some of the most aggressive H.I.V.-prevention measures in the country for pregnant women and newborns, making New Jersey one of just a handful of states with laws requiring some form of prenatal testing.
According to the Kaiser Family Foundation, which researches health issues, a dozen states require doctors to offer H.I.V. tests to their pregnant patients. But just three - New York, Connecticut and Illinois - have mandatory testing for newborn babies. Four others - Michigan, Arkansas, Texas and Tennessee - have laws similar to New Jersey's policy of testing pregnant women.
New Jersey's new law goes into effect in six months.
Prenatal H.I.V. testing laws are meant to help stem the infection of newborns. If it is known that a pregnant woman is H.I.V. positive, doctors can take steps to prevent infection like prescribing antiretroviral drugs and delivering the child through a Caesarian section.
"Early detection is the key," Senator Loretta Weinberg, a Democrat from Bergen County who sponsored the bill, said in a statement. "This measure is a huge step forward in terms of protecting all babies while helping to educate mothers."
Under the law, women will be tested early in their pregnancies and again in their third trimesters unless they refuse. If a woman refuses, it will be noted, and an H.I.V. test will be performed on the newborn unless the mother has religious objections.
According to the Kaiser Family Foundation, in 2001, New Jersey ranked 19th in the nation in the percentage of residents ages 18 to 64 who have ever been tested for H.I.V. Nearly 48 percent said they had been tested, compared with a national average of 45.6 percent, the foundation said.

HIV tests mandated for infants and moms
New Jersey is the first state to require screening for both

Thursday, December 27, 2007
Newark Star-Ledger Staff
After 16 hours of labor on Christmas Eve and one last big push, Ayesha Chase had one less thing to worry about when she gave birth to a beautiful baby boy with dark curly hair.
The 24-year-old Newark resident was tested for HIV before the birth of her son, Isaiah -- and they will soon be joined by many more people after New Jersey yesterday became the first state to require both expectant mothers and babies to be tested for the virus.
"I would recommend it; it does allow you to breathe easier and get it done and over with it," Chase said yesterday, looking tired but happy as she rested beside a sleeping Isaiah at University Hospital in Newark.
Just minutes earlier and a few doors down from Chase's room, acting Gov. Richard Codey had signed the new law, which seeks to prevent the transmission of HIV from mother to child. It takes effect in six months and requires doctors to provide the tests automatically as part of routine prenatal care.
"We're saving lives. One infant infection is one too many," said Codey who is standing in for Gov. Jon Corzine while he vacations out of state.
Before the new law was passed, New Jersey doctors were required only to offer the tests.
Julia Piwoz, a doctor at the Hackensack University Medical Center, said she wished the bill had been proposed sooner. She has treated many infants infected with the virus -- including the daughter of one woman, who was offered testing but declined because she was not a drug user and was in a committed relationship.
"I would have never tested her because the risk factors were not there," said Piwoz, chief of the Pediatric Infectious Diseases section of the Joseph M. Sanzari Children's Hospital at the medical center.
But after she delivered her baby, the woman fell ill, Piwoz said.
"This is an infection that could have been avoided," she said. "I'd love for this law to put me out of the business and not have to deal with an infected child."
Under the new bill, the screenings will be paid for by Medicaid or the insurance carrier, state officials said. The law does give an expectant mother a way to opt out of the test, but only if she raises the issue with the doctor. Even then, it will be required that the infant be screened.
When a woman tests positive for the virus, the patient will receive anti-viral drugs and, perhaps, a cesarean section if the medication isn't effective, said Arlene Bardeguez, director of HIV services in OB/GYN at University Hospital in Newark. Mothers who test positive also are counseled against breast feeding.
At University Hospital, doctors have voluntarily provided HIV testing for pregnant women for many years, Bardeguez said. In the past six years, no HIV-positive mother has passed the virus on to her child.
The mandatory tests are urgent in light of statistics in New Jersey, said Robert Johnson, interim dean of the New Jersey Medical School.
One in 313 women age 13 or older is living with HIV/AIDS in the state, according to New Jersey Department of Health statistics quoted by Johnson. Nearly three of four women with the virus are 20 to 49 -- many infected through sexual intercourse.
AIDS and HIV advocates expressed mixed feelings about mandatory screening, voicing concern for infants but noting that discrimination against AIDS carriers is still a reality. Mothers could be hurt by a positive test, they reasoned, if word got out.
"Stigma kills," said Marie Hill, a case manager at New Jersey Buddies, a nonprofit, community-based organization that supports people infected with the virus. "The ignorance of people is there."
But Hill conceded she may wind up supporting the law if infants benefit.
"It gives the right start to life," Hill said.
Dawn Breedon, an AIDS advocate based in Englewood, similarly voiced concerns about privacy issues but, in the end, considers herself a supporter of the law. She could have benefited from such a law, she said, if it had existed in 1991 when she was first diagnosed with HIV while five months pregnant with her first child.
"Back then we had no information," she said. "They just thought babies would automatically have it."
When she became pregnant with her second child in 1996, Breedon was armed with the knowledge that her baby didn't have to be born with HIV.
"I knew exactly what I needed to do back then," Breedon said.

New Jersey Targets HIV Transmissions
By TOM HESTER Jr. - 10 hours ago
TRENTON, N.J. (AP) - HIV testing will soon become part of routine prenatal care and be required for some newborns in New Jersey under a new law that supporters say is putting the state in the forefront of the national fight against HIV transmission to babies.
Acting Gov. Richard J. Codey signed the measure into law Wednesday at University Hospital in Newark. The law will take effect in six months.
"We can significantly reduce the number of infections to newborns and help break down the stigma associated with the disease," Codey said. "For newborns, early detection can be the ultimate lifesaving measure."
Codey, the acting governor while Gov. Jon S. Corzine is out of the country this week for the holidays, sponsored the bill as the Senate president.
Meanwhile, a ban in Washington, D.C., against using city money for needle-exchange programs was lifted Wednesday, a move officials say will help reduce the soaring rate of AIDS and HIV there.
A provision allowing the city to fund needle exchanges was included in the $555 billion spending bill signed by President Bush on Wednesday. Federal spending packages dating back to 1998 had previously blocked such programs.
The New Jersey bill allows women to opt out of the HIV testing, but critics contend the screening will deprive women of their right to make medical decisions.
According to the Kaiser Foundation, a nonprofit research organization focusing on U.S. health care, New Jersey is the first state to push HIV testing for both pregnant women and newborns.
Arkansas, Michigan, Tennessee and Texas require health care providers to test a mother for HIV, unless the mother asks not to be tested, while Connecticut, Illinois and New York test all newborns for HIV, according to the foundation.
New Jersey has required providers only to offer HIV testing to pregnant women. Under the new law, HIV testing will be part of routine prenatal care for all pregnant women, and doctors will provide pregnant woman with information about HIV and AIDS. It also requires newborns to be tested when the mother has tested positive or her HIV status is unknown.
Riki E. Jacobs, executive director of the Hyacinth AIDS Foundation in New Brunswick, the state's largest AIDS service agency, said the law won't help the women who don't get prenatal care.
"We need to focus on getting people into care and keeping them in care," Jacobs said. "That is our most potent prevention weapon."
The federal Centers for Disease Control and Prevention has recommended all pregnant women be tested for HIV, though it has said testing should be voluntary. The CDC also found medical intervention during pregnancy can cut mother-to-child HIV transmission from 25 percent to 2 percent.
New Jersey has about 17,600 AIDS cases, according to the Kaiser Foundation. Women represent 32.4 percent of the cases - the third highest rate in the nation. The national average is 23.4 percent.
The state has about 115,000 births per year and had seven infants born with HIV in 2005, according to state health department officials.
The American Civil Liberties Union and some women's groups contend the bill deprives women of authority to make medical decisions.
"Women's privacy rights and choices are as constitutionally valid as any other citizen, regardless of reproductive status," said Maretta J. Short, New Jersey's National Organization for Women president.
In Washington, Mayor Adrian M. Fenty said in a statement Wednesday that needle exchanges will be included in a larger city program to reduce AIDS and HIV infections. About $1 million will be devoted to the exchanges.
About 128 of every 100,000 Washington residents have AIDS, compared to 14 cases per 100,000 people nationwide, according to a recent study.
Associated Press writer Stephen Manning in Washington contributed to this report.
(This version CORRECTS group's name to 'National Organization for Women.')
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