The Latest on Women and HIV Testing

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The Latest on Women and HIV Testing
Ellen Newcomb, Program Assistant,
National Women's Law Center

Hi, this is Ellen Newcomb. I am the Program Assistant for Health and Reproductive Rights here at the National Women's Law Center. I actually want to follow up a little bit on a blog that Julia Kaye did back in January on HIV Testing of pregnant women. As it turns out, last Friday, the American College of Obstetricians and Gynecologists released a committee opinion stating that they want HIV testing on a regular basis for all women 19 to 64.

Now, in the service, this sounds like a great thing. But as I have talked with Julia and some of my other colleagues, we have kind of discovered mixed feelings about the whole thing. First just to make everything clear, ACOG has stated that they recommended opt-out testing for HIV testing. Now, there are three types of testing; there's mandated, opt-in, and opt-out. The difference between opt-in and opt-out is that in opt-in, if you went to see your physician, they would say that they could offer HIV testing if you would like it, while opt-out is your physician saying that for this visit, we, as part of all of your OBGYN tests, will test/screen you for HIV unless you specifically ask us not to.

We found, and the CDC has found, that actually the opt-out policy will get a lot more women to be tested, particularly pregnant women. With the opt-out policy, about 85-98% of women who are pregnant opt to be HIV tested, under the opt-out policy, but under the opt-in policy, it varies anywhere from about 25 to about 83%.

Some of our concerns for this policy: while it is fantastic to have women tested so that they can get treatment earlier and they can prevent the spread to their partners. Some of the concerns that we have are that we don't necessarily think that it should be just on women to be tested. We think that men should be tested on a regular basis, as well. In addition, funded counseling is not required under opt-out testing, but at the very least, we would like to see that funded counseling would be mandated to be offered.

The last concern that we have goes back to Julia's blog back in January that deals specifically with pregnant women, where the opt-out policy seems less of an opt-out policy and more like a mandated HIV testing. In some instances, if a pregnant woman decides that she does not want to be HIV tested, she will then give birth and the infant is immediately tested for HIV, the results of which will show whether or not that the mother is HIV positive. So it's less of an opt-out and more like a mandated policy.

But regardless, we are pleased that ACOG is drawing attention to the rising number of HIV cases in women, we agree that it is a fantastic thing for women to be tested for HIV so that they can get the treatment that they need and start to diminish the risk of spreading the disease to others, so it is something that you should definitely check out.

Thanks!