AIDS Organizations Urge CDC to Preserve
HIV Counseling, Informed Consent for Pregnant
Women in Policy Recommendations

In a letter sent today by 22 local, regional, and national organizations, AIDS advocates urged the CDC to continue HIV testing policies for pregnant women that promote the benefits of HIV counseling and HIV testing with informed consent.

The letter was prompted by concern among AIDS advocates that the CDC may be considering revisions to reduce or eliminate the need for HIV counseling and informed consent in its guidelines for HIV screening of pregnant women. The guidelines offer policy recommendations to help healthcare providers identify HIV-positive pregnant women who may benefit from healthcare services and reduce the chances that they might transmit HIV to their offspring.

The joint letter, organized by the AIDS Foundation of Chicago and the AIDS Legal Council of Chicago, opposes any revisions to CDC guidelines that would retreat from the current policy that pregnant women be tested for HIV only if they receive HIV counseling and give their informed consent to being tested. According to the letter, a shift in this policy would result in less frequent discussions between medical providers and their pregnant patients about ways to reduce the risks of becoming HIV infected.

Pregnant women who are HIV-positive can dramatically reduce the chance of delivering a newborn with HIV by taking antiretroviral medications like AZT during pregnancy. Before the necessary medications can be prescribed, however, HIV-positive pregnant women must be identified. Accordingly, CDC guidelines published in November 2001 recommend that all pregnant women in the United States be tested for HIV. The CDC guidelines further stated that healthcare providers should provide HIV counseling to pregnant women and that informed consent before HIV testing is "essential."

In November of 2002, the CDC published a report finding that testing methods that do not adhere to the requirements of HIV counseling and informed consent can achieve testing rates of 81% and higher. One such testing method is commonly referred to as "opt-out." Under an "opt-out" framework, pregnant women are simply told that they will be given an HIV test unless they refuse.

The coalition letter sent today to the CDC asserts that "any policy, including so-called 'opt-out' testing methods, that undermines a woman's right to informed consent to be tested and that results in a net decrease in HIV prevention education and HIV counseling-a cornerstone of our prevention efforts in the U.S.-is counterproductive and will have particularly negative consequences for pregnant women who are not currently HIV-positive but who are at high-risk of becoming infected." In other words, according to the coalition, "increased HIV testing rates at the cost of less HIV prevention aimed at pregnant women is no victory for HIV prevention in the United States."

The coalition advises a renewed commitment to providing pregnant women with information about HIV before subjecting them to an HIV test. "HIV testing and informed consent are not mutually exclusive," the coalition points out. In support, the coalition cites the CDC's November 2002 report, which noted that up to 95% of pregnant women, when appropriately counseled, will consent to HIV testing during prenatal care. The organizations concluded, "Only by providing care, including education to pregnant women, can we hope to achieve better health outcomes for them and their children."

The signatories to the letter are:

ACT UP Philadelphia
AIDS Foundation of Chicago
AIDS Legal Council of Chicago
AIDS Legal Referral Panel, San Francisco, CA
Professor Elizabeth B. Cooper, Fordham University School of Law, New York, NY
Doug Glaze Memorial Law Project, Wichita, KS
East Bay Community Law Center's HIV/AIDS Legal Unit, Berkeley, CA
Gay Men's Health Crisis, New York, NY
Howard Brown Health Center, Chicago, IL
Human Rights Campaign, Washington, DC
Human Rights Watch, New York, NY
Lambda Legal Defense and Education Fund, Chicago, IL
Legal Assistance Foundation of Metropolitan Chicago, HIV/AIDS Project
Minnesota AIDS Project
Nashville CARES
National AIDS Fund, Washington, DC
National Health Law Program, Los Angeles, CA
National Minority AIDS Council, Washington, DC
Project Inform, San Francisco, CA
Public Interest Law Office of Rochester, Rochester, NY
Test Positive Aware Network, Chicago, IL
Title II Community AIDS Network, Washington, DC
Treatment Action Group, New York, NY

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The AIDS Foundation of Chicago (AFC) is Illinois' principal advocate for people living with and at risk for HIV disease. Established in 1985 to provide central leadership in the fight against the epidemic, AFC promotes sound HIV/AIDS public policy, funds HIV/AIDS care and prevention projects, and through its Service Providers Council, helps to coordinate the delivery of essential HIV/AIDS services. The AIDS Legal Council of Chicago works to preserve, promote and protect the legal rights of men, women and children in the metropolitan Chicago area living with HIV/AIDS. The Council provides direct legal services to people in need, educates consumers, service providers, and the public about HIV-related legal issues and advocates for social policies that ensure fair treatment for all people affected by HIV/AIDS.

Coalition Letter