Department of Health Recommends Pregnant Women Undergo Voluntary HIV Testing

For Immediate Release: February 5, 2008
Media Contact: Communication Office
Vermont Department of Health

BURLINGTON – The Vermont Department of Health is supporting Centers for Disease Control and Prevention (CDC) guidelines that recommend all pregnant women are screened for HIV as part of standard tests performed by a health care provider, unless women decline the test.

Infected pregnant women can pass HIV to their baby during pregnancy or delivery, as well as through breast-feeding. HIV transmission from mother to child during pregnancy, labor, delivery, or breastfeeding is called perinatal transmission.

The intent of the new recommendations is to decrease the possibility of perinatal transmission of HIV, the virus that causes AIDS.

Perinatal HIV transmission is the most common route of HIV infection in children and is now the source of almost all AIDS cases in children in the United States, according to the CDC.

“We are encouraging providers to make HIV screening part of the routine battery of tests that all women in prenatal care receive to protect the health of their babies,” said Health Commissioner Sharon Moffatt, RN, MSN. “Even though our rates of HIV are low on a national scale, if we can prevent even one case of mother to child transmission by issuing this recommendation we will have achieved our goal.”

Perinatal transmission rates of HIV from mother to child are reduced from 25 percent to less than 2 percent if the woman is screened and, if positive for the virus, receives treatment with antiretroviral drugs, decides to have a cesarean delivery, and avoids breastfeeding.

The CDC issued revised recommendations for HIV testing of pregnant women in health care settings on September 22, 2006. In 2007, the Health Department initiated a process of consultation and review with Vermont leaders in obstetrics and HIV treatment to craft new testing guidelines suited to meet the needs of pregnant Vermonters. The new Vermont guidelines were mailed to medical providers on Feb. 5, 2008.

Vermont’s previous approach was health care providers offered women pre-HIV test counseling and then asked the women to consent to an HIV-antibody test (‘opt-in’ screening). Under the new approach, HIV screening is recommended by the health care provider and women are notified that testing will be performed unless they decline (‘opt-out’ screening).

CDC data from other states that have adopted the ‘opt-out’ approach shows a significant increase in the percent of women screened. For example in Arkansas the rate went from 57 percent to 71 percent within a two-year period.

Vermont data from 2004 shows that only 62 percent had an HIV test during pregnancy, 21 percent declined the test and 17 percent were not offered an HIV test.

Approximately 25 percent of all people infected with HIV do not know their HIV status. If women are tested early in their pregnancy, those who are infected can be given therapy to improve their own health and reduce the risk of transmitting HIV to the baby.

Since the beginning of the epidemic in 1981, AIDS has been diagnosed for an estimated 8,460 children who were infected perinatally, and an estimated 4,800 (57 percent) of those children died.

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