Should All Pregnant Women Be Tested for HIV? Essay Example

When it comes to a woman’s right of choice there is a great deal of controversial debate. One issue that has been a commonly argued point is whether or not a pregnant woman should be required to have an HIV test. HIV is an epidemic amongst women during childbearing ages and can be passed to the child during the birth process (Duggan et al, 2003). At this point women are not required to be tested, even though there was an estimated 45.3 million with HIV in 2005 (Schuklenk & Kleinsmidt, 2007). More than 35% of newborns born to HIV infected mothers contract the disease, which causes an estimated 600,000 million new infects cases every year (Schuklenk & Kleinsmidt, 2007). Those promoting required HIV testing argue that countless new infections and loss of life could be prevented, while those against argue that it is a violation of a woman’s civil rights. That leaves the controversial question; should a pregnant woman be required to have an HIV test?

Pros Of The Argument

• Those that propose required HIV testing for pregnant women suggest that by testing, treatment can begin earlier to prevent or greatly reduce the risk of transmission from the mother to the newborn baby (Schuklenk & Kleinsmidt, 2007). Because HIV is a silent disease in the early stages some woman may not even be aware of their infection. By testing all pregnant women the infection could be diagnosed earlier and therefore protect both the mother as well as child through early treatment. There are treatments available to reduce the viral aspect of the disease, therefore reducing the count of antibodies in the mother, and reducing the transmission to the newborn.
• In the 1990’s a new medical technology provided the ability to test for HIV through what is known as a rapid test. The ability to test in a quicker and more efficient manner is a benefit that allows women to know the status of their health during their pregnancy and reduce transmission of HIV by >2% (Smith et al, 2007). Granted, there is a harm reduction for the woman through allowing her to know whether or not she is infected, however it is also a benefit for both the unborn baby and society in general. The spread of sexually transmitted diseases is a concern for all and taking more of a preventative stance could greatly benefit all.
• HIV is a virus that can be transmitted to others through contact of infected bodily fluids, such as semen, saliva and blood (Duggan et al, 2003). This is especially true for health care providers and it is important that they are aware of their patient’s history to protect themselves, as well as provide the best care possible to the patient. There can be complications through any medical procedure and if a doctor is not aware of a patient’s medical conditions or illness, he/she may not be able to provide the best care. A mother, who is aware of her HIV, would be able to prevent the spread to others, knowing that she is positive. These precautions could be through practicing safe sex, avoiding breast feeding and taking universal precautions.
• Testing for HIV during pregnancy would provide peace of mind for the woman in regards to her own health and that of her baby. If she tested positive it would allow her to make better health care decisions and also learn more about treatment (APA, 2007). Because of the progression and seriousness of the disease, women are more susceptible to other viruses and infections, because of the weakened immune system. By knowing that she is positive, she is then able to get treatment and prevent many of the negatives of the disease. Counseling could also be engaged in to obtain educational materials to better cope with the illness. Just like any other medical condition it is important for individuals to be proactive and attempt to prevent the furthering of the disease.

Con Arguments

• One of the leading concerns in requiring HIV testing in pregnancy is the violation of the woman’s health information and privacy (Schuklenk & Kleinsmidt, 2007). Health information is strictly guarded and protected by federal law, which makes it difficult to require a woman to have a specific test. Other concerns such as a social stigma or out casting behavior are feared as the woman could be labeled as having a contagious and potentially fatal disease. Some fear that this could lead to her receiving less than adequate treatment and suffer socially.
• One of the arguments against requiring HIV testing during pregnancy is the cost factor. Many argue that the cost of the test would create a hardship on the individual and the additional stress during pregnancy is not advisable for obvious reasons. Pregnancy can be a costly health condition that spans for 11 months and many argue that they simply cannot afford the additional expense of testing (ACLU, 2001).
• AZT is a prescription drug approved by the FDA for the treatment of the HIV infection. While AZT has been proven to reduce the transmission of HIV to the newborn the efficiency is not 100%. One of the leading problems with AZT treatment is that it can be toxic and some argue that it is not worth the risk of potentially ceasing the transmission (ACLU, 2001).
• HIV places a woman at more risk during her pregnancy. Along with the possibility of early labor and low birth weight for the baby there are also health concerns for the mother as well. Other concerns such as still births and Amnionitis, which is an infection or abnormal growth of bacteria in the uterus, amniotic sac and can even spread to the fetus (APA, 2007). This can place a great deal of stress on both the mother and baby, which can lead to a spontaneous abortion, which can be devastating.

In conclusion, HIV is a deadly disease that takes the lives of many every year. It can be potentially fatal to newborns if transmitted from their mothers. While there are some concerns of breaching the mother’s privacy, cost and treatment with dangerous medication it seems that saving the life of an innocent baby would be the determining factor.

References

Duggan, J., Khuder, S., Sinha, N., & Chakraborty, J. (2003). Survey of Physician Attitudes Toward HIV Testing in Pregnant Women in Ohio. AIDS Patient Care and STDs, 17(3), 121-127.

HIV/AIDS during Pregnancy : American Pregnancy Association (APA). (April 2007). Promoting Pregnancy Wellness: American Pregnancy Association. Retrieved June 6, 2011, from http://www.americanpregnancy

HIV Testing of Pregnant Women and Newborns | American Civil Liberties Union. (2001, January 1). American Civil Liberties Union. Retrieved June 5, 2011, from http://www.aclu.org/lgbt-rights_hiv-aids/hiv-testing-pregnant-women-and-newborns

Schuklenk, Udo PhD, & Kleinsmidt, A, LLB, LLM. “Rethinking Mandatory HIV Testing During Pregnancy in Areas With High HIV Prevalence Rates: Ethical and Policy Issues.” American Journal of Public Health 97.7 (2007): 1179-1183.

Smith, C., Battin, M., Francis, L., & Jacobson, J. (2007). Should Rapid Tests For HIV Infection Now Be Mandatory During Pregnancy? Global Differences in Scarcity and A Dilemma of Technological Advance. Developing World Bioethics, 7(2), 86-103.