Mandatory Prenatal HIV Testing

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