Reducing HIV/AIDS infection in babies and improving the health of pregnant women with HIV/AIDS: A legislative Rx

Issues: In a survey of obstetric providers, nearly 70% reported that the opt-in approach to prenatal HIV testing, which requires informed consent and is a requirement in most states, is a barrier to testing all pregnant women for HIV. Furthermore, data indicate that states requiring the opt-in testing approach have lower testing rates than states using the opt-out approach, where the pregnant woman is notified that she will be tested for HIV along with the other routine prenatal blood tests unless she declines.

Project Description: To encourage uniform state laws and regulations requiring universal, routine HIV testing for pregnant women using the opt-out approach, ACOG developed activities and materials, including an HIV toolkit with suggested legislative language, to assist state policymakers, public health officials, and other MCH advocates working to create new state opt-out testing requirements or revise existing laws and regulations to reflect that approach.

Results: ACOG monitors state HIV testing laws and regulations and advises physicians and other lobbyists working to change prenatal/perinatal HIV testing policy. The toolkit was distributed to state legislative health committee chairs and HIV/AIDS and MCH advocates in early 2006 and is available upon request. Two states improved their laws following ACOG input.

Next Steps: Policymakers, obstetric providers, and public health leaders in several states are examining current requirements for HIV testing of pregnant women and have contacted ACOG for consultation on appropriate law language and strategies to make state requirements consistent with national guidelines.