Futurestork,
there are two philosophies being used in USA regarding HIV testing during labor -- from:
here are the two approaches. I coudln't find a listing of what each state is doing; it seems New York & Connecticut are the most strict which is good since treating with antiretrovirals during labor has been proven to reduce transmission from 25% to less than 2 % ....
http://www.cdc.gov/hiv/projects/perinatal/materials/C_1.htm
What approaches to prenatal testing are currently used in the United States?
* Opt-out: Pregnant women are notified that an HIV test will be routinely included in the standard battery of prenatal tests for all pregnant women, unless they decline HIV testing. This is the current standard recommended by the CDC.
* Opt-in: Pregnant women are provided with pre-HIV test counseling and must specifically consent to an HIV antibody test, usually in writing.
* In addition, in cases where the mothers HIV status is unknown at delivery, some states mandate that newborns be tested for maternal HIV-antibody, with or without the mothers consent, if the mothers HIV status is unknown at delivery. Results must be available within 12 hours of birth in New York and within 48 hours in Connecticut, the two states that have implemented this approach.
What are some of the advantages of routine prenatal testing with the right to decline-- the opt-out approach?
The opt-out approach is expected to substantially increase testing rates among pregnant women, based on new information from the U.S., Canada, Europe, and Africa. This approach should increase the proportion of HIV-infected women who are offered appropriate antiretroviral and obstetrical interventions to prevent perinatal HIV transmission and to protect the womans own health.
Data indicate that women are more likely to accept testing when it is offered and recommended by their prenatal care providers. But some providers continue to find requirements for extensive pre-test counseling and consent documentation to be barriers to offering the test. The opt-out approach is designed to reduce those barriers while preserving the voluntary nature of testing and increasing the opportunity for all pregnant women to have HIV screening.
How would the opt-out approach be implemented?
The simplest approach requires notifying the pregnant woman that an HIV test is performed as part of the standard battery of prenatal tests, but that the woman can decline the test with documentation of her refusal in the medical chart. Another approach might be to document a pregnant womans consent for the routine battery of prenatal tests, including HIV screening, and, if she declines HIV testing, to document this in her medical chart. CDC recommends that pregnant women, at minimum, be given a brochure on prevention of perinatal HIV transmission and treatment of maternal HIV.