Norma,
The New York State Law on HIV is at the following web site.

Http://www.hivguidelines.org/public_html/left/policy/hiv_counseling_policy.htm


The law is such that a pregnant mother can decline the test but her infant
will be tested.  The test on the infant will determine the hiv status of the
mother not the hiv status of the infant.

Here is an article from American medical news on the testing:
http://www.ama-assn.org/amednews/2000/03/13/hlsa0313.htm

"A high rate of false-positives with a widely used test to screen women in
labor for HIV leads to unnecessary antiretroviral therapy for infants, mothers.

By <A HREF="http://www.ama-assn.org/amednews/site/bio.htm#shelton">Deborah L. Shelton</A>, AMNews staff. March 13, 2000. New York health
officials are facing an unexpected hurdle in their efforts to identify newborns whose
mothers may have exposed them to HIV in utero. A state regulation went into
effect in August 1999 that requires hospitals and birthing centers to test
within 48 hours all women who present for labor and whose HIV status is unknown.
Under the new requirements, babies are routinely screened at birth with the same
test if their mothers decline it. But such tests are not always accurate and
used appropriately. Preliminary health department data for August through
November 1999 showed that screening with a rapid HIV test identified 32
HIV-positive women. After using a confirmatory test, however, 17 women were later
determined to be HIV-negative. In the meantime, 13 of the 17 babies were started on
preventive antiretroviral treatment. Babies treated with zidovudine, the
standard preventive therapy, can develop anemia. The long-term effects of the drug
are unknown. The findings, released in January, raise concerns among doctors
in the state that the single-use diagnostic system produces an unacceptably
high rate of false-positive results. The test can be completed in less than an
hour, instead of the usual two to four hours for the ELISA and Western blot
tests. It is the only rapid HIV screening test approved by the Food and Drug
Administration and has been used in the United States since 1994."

According to the Baylor College of Medicine HIV Nursing Curriculum(2001) a
HIV diagnosis to confirm HIV infection of infants should be done with PCR (the
New York State law seems to be using the the same test as used on
mothers--ELISA/Western Blot--antibody testing with high false positive rates).  "The PCR
should be performed after the infant is one month old (because test is less
sensitive after one month) and it should be done on two separate occasions.

Thus treatment may commence without true infection.  Antiretrovirals are
DNA-chain terminating drugs and thus one would think that they should not be used
on healthy, non-infected individuals.  And of course breastfeeding will be
"discouraged."  Other states in the USA maybe considering this kind of law--here
in Florida I hear rumblings about the need for this kind of law.  It is a law
that circumvents informed consent and does not allow the mother to truly
decline testing.  And the weird thing about it is that the testing does not tell
anyone anything about the status of the infant.  So is this about protecting the
infant?

The pregnant mother may want to visit the website at aliveandwell (founded by
Christine Maggiore) and make contact with that organization.
http://www.aliveandwell.org/index.php?page=proveit&category=6

or anotherlook at
http://www.anotherlook.org

Valerie W. McClain, IBCLC







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