Finally had a chance to read Wednesday's(2/21/96) editorial of our
English-Language paper, the San Juan Star.

POLITICS OF AIDS IS KILLING 1,600 INFANTS PER YEAR
        Acts of political terrorism that injure children outrage every decent
person.   But the politics of AIDS is harming babies as surely as a grenade
tossed into a nursery.  Because some assert that AIDS-testing pregnant women
"Stigmatizes" them, health authorities shrink from mandating tests.  So about
980 healthy-born infants each year needlessly contract the virus from mother's
milk;  another 600, who could have been spared from infection by prenatal drug
therapy, are born HIV positive.
        This de-facto death sentence for almost 1600 children, notes Heritage
Foundation researcher Patrick Fagan, could in many cases be commuted by sane
public policy.  such a policy would treat AIDS first as the health threat it is,
second as an issue of civil liberties.
        Facts help.  About 7000 HIV-positive mothers give birth in America each
year.  Luckily, some 5200 (75 percent) of their babies are born HIV-free (though
another 14 percent will get AIDS via breast milk).  Of the 25 percent born
HIV-positive, two-thirds could be immunized if their mothers took AZT while
pregnant and if the babies recieved it after birth.  In sum, we could save all
but about 560 of the at-risk tots - but only if there were universal AIDS
testing of pregnant women.
        Some states require couples to take a syphilis test before marriage.
Meanwhile, compulsory testing for AIDS - unlike syphilis, incurable and fatal -
is politically off-limits.  It makes no sense.
        Neither of two AIDS bills now being merged by a congressional conference
committee compels AIDS-testing of women.  But the stronger, better House measure
would urge states to make mandatory testin of expectant mothers a "standard of
care."
        It also would require states, upon pain of losing federal AIDS funds, to
test all newborns whose mothers had not been tested.  This at least would allow
HIV-positive babies - and their infected mothers - to receive appropriate care.
Only the women and their attending physicians would know the test results.
        The status quo may satisfy some AIDS activists, civil libertarians of the
looniest sort, and certain politicians who do not recognize human personhood
until the species attains, roughly speaking, voting age.  But it should horrify
the rest of us, or we are beyond horror.
                                Scripps Howard News Service


Are those statistics correct?  Please respond to the paper directly (San Juan
Star, PO Box 364187, San Juan, PR  00936-4187 or fax to (809)782-0310.

I have worked in a federally funded community health center, and am very aware
of the difficulty of maintaining records confidential - the mom and her doctor
_will not_ be the only ones aware of the results - or even of the fact the test
was ordered.  However, the cost-benefit ratio is different - and with PR being
one of the places in the US with the highest number of AIDS cases per
population, it may be that mandatory testing is a necessary alternative.

I do want to get the statistics and risks of breastfeeding straight - here we
are, working with the School of Public Health trying to educate the nurses and
educators on the ways to promote breastfeeding - and they are very aware of the
AIDS risks in their populations.  How do we balance the two?  There are safe
(thanks to WIC) formula alternatives, so this is not one of those countries that
the WHO says should breastfeed even if there is a risk of exposing the baby to
AIDS due to the lack of suitable, safe, alternative feeding methods.

I would appreciate your feedback.

Jeanette Panchula, BSW,LLLL,IBCLC, RN
Puerto Rico
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