Prenatal Screening for HIV

In this study, zidovudine therapy was administered viva voce to with child(predicate) women and intravenously during labor. The infants received oral zidovudine for sextet weeks after birth. The researchers concluded that use of zidovudine reduced the run a risk of human immunodeficiency virus transmission in the infants by two-thirds, or from 25.5 percent to 8.3 percent.

A set of globe health recommendations was issued establish on the results of the study. The guidelines strongly supported offering voluntary HIV examen and counseling to significant women. For those pregnant women who test positive, NIH and other public health institutions urged counseling and the use of zidovudine to prevent perinatal HIV transmitting. Many federal, state, and medical organizations wear since articulated positions in support of the task force recommendations and feel taken sign steps towards implementation of perinatal HIV prevention programs. some(prenominal) federal programs have provided funding to cover the cost of the zidovudine, and states have been urged to pay for HIV counseling, education, and voluntary exam programs. While many another(prenominal) states have legislated the promotion of HIV counseling and testing, some have gone so far as to mandate that HIV tests are offered to all pregnant women and required in newborns.

As a result of these guidelines, a significant decrease in the pediatric HIV epidemic has been predicted. However, behavioral, ethical, and cultural factors impact some(prenominal) the implementation of mandat

4. Landesman, S. H., Kalish, L. A., Burns, D. N. Minkoff, H., et al. Obstetrical factors and the transmission of human immunodeficiency virus type 1 from mother to child. N Engl J. 334:1617-1623; 1996.

The issue of mandated testing for pregnant mothers and infants is politically charged. In June 1996, the American Medical Association (AMA) endorsed mandatory testing of all pregnant women and newborns for HIV. While the AMA policy has no direct legal implications, the size of the organization (approximately half of the nation's doctors are members) makes it highly influential.

Supporters of the endorsement based their position on the NIH clinical trial which demonstrated the strength for a significant reduction in risk of transmission, providing HIV-positive pregnant women are identified and comply with the course of therapeutic treatment. Those contend express concerns that such a legal mandate would dissuade those most at risk for AIDS from seeking antenatal care. Those voting against the endorsement preferred a voluntary testing program.

A number of factors contributed to this relatively low acceptance rate. First, a perception in the community that zidovudine was ineffective or that it was still an "experimental" drug may have arisen from commingle reports on the drug's efficacy and toxicity. Additionally, the press given wide coverage to new antiretroviral drugs that may be superior to zidovudine. Substance shout prior to and during pregnancy was positively correlated with refusal of zidovudine therapy and little than complete compliance in those who chose therapy. Researchers concluded that prophylactic therapies in certain populations and settings may not be widely certain despite comprehensive counseling, education, and multidisciplinary team care.

6. Simonds, R. J., Edlin, B. R., Rogers, M. F. Preventing perinatal HIV infection: how far have we come? JAMA. 275:1514-1515; 1996.

New antiviral drugs becoming available are reported to be more
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