Mandatory prenatal HIV testing

epidermnurse · May 14, 2009

It's my understanding that it has become law in high risk states. I live in Baltimore and we run an HIV test on all Moms if it wasn't done during prenatal care. I haven't tried to look it up--I'd be interested to see the actual written law.

Jolie, BSN · May 14, 2009

HIV testing is an important part of prenatal care, and I believe it is the standard of care to include it in routine prenatal labs.

But I know of no situation where a patient can be required to submit to a medical test against their will, unless there is a court-order or they are not competent to make their own health care decisions (such as someone under a legal guardianship).

If a patient expressly refuses an HIV test, I would not do one. If there is a compelling reason for it to be done, turf it up to your spervisor and the legal team of your institution.

I guess the important question here is why hasn't it been done, and who is insisting on it?

APBT mom, LPN, RN · May 15, 2009

In Florida it's not a law. It's a recommendation from ACOG. They recommend what testing should be done and at what time. If you search the website the pamplets related to testing for certain things will pop up.

Like the poster mentioned above. No one can force the patient to allow testing for it without a judge deeming them incompetent.

mitchsmom · May 15, 2009

In Florida it's not a law. It's a recommendation from ACOG. They recommend what testing should be done and at what time. If you search the website the pamplets related to testing for certain things will pop up.
Like the poster mentioned above. No one can force the patient to allow testing for it without a judge deeming them incompetent.

That's what I was thinking/ wondering when I saw the note...

HappyNurse2005, RN · May 15, 2009

No, its not mandatory here. Sure, most women get it. Some don't. It's recommended, but, correct me if i'm wrong, but don't they have to sign a specific consent for a HIV test? so you can't just test them on admission, b/c they didn't consent to that? the only ppl we test at the hospital are those who have been part of an accidental exposure, and those who come in and have had no prenatal care at all. those ones, we ask if they want one, don't just do it. I've been in l&d for 3 years, almost, in a pretty busy hospital (300-340 deliveries a month) and i've only taken care of 2 HIV positive women. there's been a small amount more, that i haven't cared for, but not that many, i dont think

though, i went with a friend of mine to her initial OB appt back in Nov 2006. They gave her the consent to HIV testing and said "This is permission to draw your blood". thats it. she was a nurse, and read what she was signing, and didn't mind having an HIV test....but, hey, there's consent for you:)

Elvish, BSN, DNP, RN, NP · May 15, 2009

In my state it's law. I don't like it, as I think it's too intrusive. But either mom consents to an HIV test during pregnancy, or we draw the baby's HIV once he's born. I don't like it, like I said. If I had a patient refuse, I'd still honor it.

That said, we have found a few HIV+ moms that would not have otherwise been diagnosed.

chudy · May 15, 2009

Hi everyone.

I am currently 8mths pregnant and live in nassua county, NY. During my first prenatal visit the nurse told me that I have to take a mandatory hiv test at the begining and towards the end of the pregnancy. I guess it is a requirement now for some states I believe. Six years ago I remember that they usually ask if you would like to have a hiv test during your first prenatal blood work up.

morte, LPN, LVN · May 15, 2009

In my state it's law. I don't like it, as I think it's too intrusive. But either mom consents to an HIV test during pregnancy, or we draw the baby's HIV once he's born. I don't like it, like I said. If I had a patient refuse, I'd still honor it.
That said, we have found a few HIV+ moms that would not have otherwise been diagnosed.

but is it the law, or the hospital's wishes? we DO know they arent always one and the same, dont we?

have you seen the law? officially, not just been told?

very curious.......

morte, LPN, LVN · May 15, 2009

Hi everyone.
I am currently 8mths pregnant and live in nassua county, NY. During my first prenatal visit the nurse told me that I have to take a mandatory hiv test at the begining and towards the end of the pregnancy. I guess it is a requirement now for some states I believe. Six years ago I remember that they usually ask if you would like to have a hiv test during your first prenatal blood work up.

i would be asking to see the law......

Elvish, BSN, DNP, RN, NP · May 15, 2009

but is it the law, or the hospital's wishes? we DO know they arent always one and the same, dont we?
have you seen the law? officially, not just been told?
very curious.......

We have a copy of the statute in our breakroom; it is opt-out, so basically it's automatically done unless mom says no. If not done prenatally, it's done at delivery. If mom refuses then, we draw an HIV on the baby.

morte, LPN, LVN · May 15, 2009

We have a copy of the statute in our breakroom; it is opt-out, so basically it's automatically done unless mom says no. If not done prenatally, it's done at delivery. If mom refuses then, we draw an HIV on the baby.

at least you are on sound footing....but why are these women given less legal protection than men?

and if she explicitly forbids her baby from being tested, what happens? besides the fact that it isnt very good testing......