Online Program

Current legal and policy environment for STI testing in pregnancy

Tuesday, November 5, 2013

Karla Schmitt, PhD, MPH, ARNP, College of Nursing, Florida State University, Tallahassee, FL
Marshall Kapp, JD MPH, Center for Innovative Collaboration in Medicine and Law, Florida State University, Tallahassee, FL
Jacob Zicarelli, JD, College of Law, Florida State University, Tallahassee, FL
Background: The national regulatory environment has long contained provisions relating to direct testing for sexually transmitted infections (STIs) during pregnancy. Over time, changes have been made to requirements pertaining to specific organisms, provider reporting responsibilities, and timing of testing during pregnancy. Emphasis recently has focused on screening for HIV, with very limited attention to other STIs also associated with adverse pregnancy outcomes. Objectives: To analyze the current law regulating practice with regard to testing and case reporting of STIs during pregnancy. Methods: LEXIS/NEXIS was searched to identify state statutes and regulations relating to testing for STIs during pregnancy Results: Five states have no testing requirements. Four states have opt–in requirements and the rest have some form of opt-out requirement. Most states require only syphilis, hepatitis B and HIV testing. Few require written consent to testing. Eight jurisdictions permit exemption based on religious objections, while four others permit judges or physicians to waive the requirement. Great variability is noted in the time interval to report cases to public health authorities, and few states require that women receive notification of their test results. Conclusions: Findings have implication for targeted regulatory changes to enhance testing practice and expansion of electronic laboratory reporting to improve STI case management in pregnancy.

Learning Areas:

Provision of health care to the public
Public health or related laws, regulations, standards, or guidelines

Learning Objectives:
Describe the scope of legally required testing for sexually transmitted infections during pregnancy. Discuss regulatory policy strategies to improve timely screening and treatment for chlamydia infection during pregnancy.

Keyword(s): Law, Public Health Policy

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the principal or co-principal of multiple federally funded grants focusing on the sexually transmitted disease case management, surveillance and notifiable disease reporting. Among my scientific interests has been implementation of regulatory policies and program initiatives to improve pregnancy outcomes associated with sexually transmitted infections.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.