HIV testing of pregnant women: a policy analysis.
The promising findings of ACTG 076, which identified a hopeful strategy for substantially reducing HIV transmission from mother to fetus, has stimulated a debate on counseling and testing protocols for pregnant women. This article presents an analysis of five state policy alternatives that address HIV counseling and testing. The policy analysis utilizes vertical and horizontal equity, user preference including avoidance of stigma and the right to privacy, effectiveness, and feasibility as evaluative criteria for examination of the policies. Interviews with state health department personnel enhance the policy analysis. While universal HIV counseling and voluntary testing for pregnant women emerges as the most acceptable policy, public health professionals must assume a vital role in facilitating the adoption of ethical and just state policies in an atmosphere sometimes hostile to women at risk for HIV.
Lovvorn
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AE
Family Health International, Research Triangle Park, NC 27709, USA.
Quinn
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SC
Jolly
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DH
D015492:AIDS Serodiagnosis / Q000592:standards*; D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use; D003376:Counseling; D005260:Female; D015658:HIV Infections / Q000151:congenital / Q000188:drug therapy / Q000517:prevention & control* / Q000635:transmission; D006291:Health Policy / Q000331:legislation & jurisprudence*; D006801:Humans; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical; D018580:Mandatory Testing / Q000331:legislation & jurisprudence*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis* / Q000188:drug therapy / Q000276:immunology* / Q000821:virology; D018907:Privacy; D012935:Social Justice; D014481:United States; D014933:Women's Rights; D015215:Zidovudine / Q000627:therapeutic use
D019380:Anti-HIV Agents; D015215:Zidovudine