# Mandatory HIV testing



## Freud (Jan 21, 2008)

So, I had another thread on here about this a while back, but it seems the law has since changed. Basically, the law in Illinois states that the mother must have an HIV test during her pregnancy or her newborn will be tested without her consent. It seems that the new law has deleted the part of the old law that allowed for religious exemptions.

What can be done about this? This can't be possible. It's unconstitutional. How would one go about refusing both tests? I'm not pregnant, but this outrages me. The only people who are mandated by law to get HIV tests are felons and pedophiles, now we're adding women and newborns??


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## ishyfishie (Dec 20, 2006)

I've been told this is the law in NY as well.


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## MaterPrimaePuellae (Oct 30, 2007)

The midwife told me this was the case in SC as well. The whole thing makes me pretty angry, too


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## frugalmama (Sep 12, 2009)

Law in TX here too - they tested me not once, not twice, but THREE times during my pregnancy and after the birth.


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## Freud (Jan 21, 2008)

Yikes! I wonder how this passed in so many states. It's for sure unconstitutional. I wonder if those who homebirth with a midwife are subjected to that same protocols.


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## nia82 (May 6, 2008)

I was told that in CA two years ago. I did it cause I didn't want DS to go through the blood draw. I am sort of used to it, had to do it for immigration and tried to see if that test was ok with them, but of course they say you could have caught it recently.


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## littlecityfarmer (Apr 27, 2004)

HIV test is mandatory in NY, with every pregnancy-- not sure about in homebirths, though. I'd imagine that unless somebody UC'd, mom and/or baby would be tested.

I don't have any overwhelming philosophical opposition to HIV testing, though I do think it is a waste of resources to mandate testing across the board, since people who are in a long-term monogamous relationships with clean partners and/or diligant about practicing safe-sex (when not TTC, that is







.) are at low-risk for contracting HIV. It would be sensible, however, to test people with a history of risk factors (IV drug use, risky sex with multiple partners, early 1980s blood transfusions, etc)-- some women may only receive medical care, or only have insurance, during their pregnancies, and universal testing probably helps get some people into treatment that otherwise wouldn't have been diagnosed, and for that reason it makes sense to me from public health standpoint. I doubt medical professionals want to be punative with the results-- that would be highly unethical, anyway--but they do want to make sure that any potential complications that might occur in an HIV+ pregnancy are accounted for.

Every pregnancy, I've been counseled about testing. Every pregnancy, I've said "I'm in a mutually monogamous relationship with my husband. I have no doubts about his fidelity, and I would be extremely surprised, but would have plenty of family and community support, if I tested positive." Every pregnancy, I've (as predicted) tested negative. However, the test itself was relatively painless-- what's another tube of blood when you're already having 7 drawn (I have complicated pregnancies and have to get lots of blood drawn, anyway)?


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## ishyfishie (Dec 20, 2006)

I'll ask my homebirth midwife about it tomorrow--I think I was tested along with the other "pregnancy bloodwork" she sent me for at the beginning, but with my last pregnancy, the (hospital-based) midwives specifically talked about the state law stuff so maybe it wasn't included this time. I'll find out and report back after my appointment tomorrow evening!


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## emnic77 (Sep 12, 2009)

I have no problem with HIV testing. It's possible to get HIV without involving sex or dirty needle sharing, however slim, and my midwife is going to be dealing with all sorts of my bodily fluids, so I have no issue with being tested along with the initial blood draw.

That said, I have HUGE issues with any state MANDATING any sort of testing, just like I have problems with any sort of mandated vaccination or any other mandated health policy. Leave it to hospitals or health care providers. If they want to have a policy that says we won't provide care unless you have this test, that's their prerogative, but it's absolutely no business of the state IMO.


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## soso-lynn (Dec 11, 2007)

Quote:


Originally Posted by *Freud* 
The only people who are mandated by law to get HIV tests are felons and pedophiles, now we're adding women and newborns??

That statement is just horrible on so many levels.

I think that every pregnant woman should get tested for HIV. With proper care, the transmission rate becomes practically non-existent so there is a huge benefit to finding out as soon as possible. If a newborn is tested immediately after birth, medication can be given to prevent sero-conversion and that is very much time-dependent. The whole "I trust my partner" line as been proven to put a lot of people at risk in many situations and there are other ways of catching it. I also think that for HCPs to try to distinguish between high-risk and low-risk people is a great way to start being judgemental and discriminating.

That being said, any law that forces any kind of medical procedure or testing on anyone is obviously wrong. I do think that that kind of extreme measure is to be expected in American culture. A lot of it has to do with the health care system that is run as a business. In most other countries, a simple directive encouraging a certain standard of care is sufficient to achieve public health goals. Informed consent is still the official standard an anything can be opted out of with a simple no, no need for religious or other exemptions. With the American system, the only way the government can force doctors to do anything is through a law and the only way people can circumvent a law is by invoking some other legal right like freedom of religion.


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## Freud (Jan 21, 2008)

I totally agree with the previous two posters. There is nothing inherently wrong with HIV testing or even having a _policy_ that all pregnant women be tested. The problem is the mandating of such procedures (without writing into the law the right to religious exemption) which are unconstitutional. I think we've been on a slippery slope with health care, as the government thinks they know how to better manage our health care than our trusted (hopefully) doctors whom we have chosen to entrust our general health and the health of our unborn babies. HIV testing in pregnancy, especially mandated testing, is a touchy subject because of the risk of a false positive and then being forced to take very strong medications that can impact the unborn baby. Can you image the outrage if a woman received a false positive and was given AZT during pregnancy and then found out that she was in fact negative? Huge legal, medical, and ethical ramifications.


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## mamabadger (Apr 21, 2006)

If I understand the statistics correctly, when you test a low risk population for a relatively rare condition, you tend to get many more false positives than true positives. Considering the consequences of a positive HIV test, for both mother and baby, the potential for harm is enormous.


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## RedPony (May 24, 2005)

Quote:


Originally Posted by *soso-lynn* 
I think that every pregnant woman should get tested for HIV.

If I tell my HCP provider that there's NO CHANCE of me having HIV, why should I be tested? I haven't been (tested) during pregnancy nor have my babies. There's ZERO chance I've contracted HIV, which I didn't have to prove to my midwife, which is one of the millions of reasons I chose to have a homebirth. I'm glad I had this freedom and I think all women should have it.


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## Belle (Feb 6, 2005)

I declined to have an HIV test during my first pregnancy and the OB nurse was very pushy about it. She said scary stuff like I could kill my newborn if I tried to breastfeed and I was HIV positive. I still declined. I knew I would not be positive.

My HB midwives for my second pregnancy offered it to me. They were not pushy, just letting me know that it was available if I wanted it. I declined and it was no big deal. I miscarried that pregnancy and ended up with a blood transfusion so...

My third pregnancy with the same midwives I opted for the HIV test. I wouldn't have done it if I hadn't had a blood transfusion. I'd have passed on the prenatal blood testing altogether.

It may be no big deal for some women to give another vial of blood but for me it is nothing less than torture to draw blood. I completely freak out and go into full blown panic mode. For some reason, having my finger pricked to check my iron doesn't bother me at all but a needle in my vein is terrible. This has gotten worse since my miscarriage. I think being completely unable to move and having people unsuccessfully try to stick needles into both arms while I was bleeding to death may have contributed a little to this.


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## elmh23 (Jul 1, 2004)

Quote:


Originally Posted by *RedPony* 
If I tell my HCP provider that there's NO CHANCE of me having HIV, why should I be tested? I haven't been (tested) during pregnancy nor have my babies. There's ZERO chance I've contracted HIV, which I didn't have to prove to my midwife, which is one of the millions of reasons I chose to have a homebirth. I'm glad I had this freedom and I think all women should have it.

How do you know that there was no chance? Presumably you had sex to get pregnant, which is a way to contact HIV. While you trust your partner, they might be seeing someone on the side that you don't know about. This is one of the ways HIV is transmitted.


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## soso-lynn (Dec 11, 2007)

Quote:


Originally Posted by *Freud* 
I totally agree with the previous two posters. There is nothing inherently wrong with HIV testing or even having a _policy_ that all pregnant women be tested. The problem is the mandating of such procedures (without writing into the law the right to religious exemption) which are unconstitutional. I think we've been on a slippery slope with health care, as the government thinks they know how to better manage our health care than our trusted (hopefully) doctors whom we have chosen to entrust our general health and the health of our unborn babies. HIV testing in pregnancy, especially mandated testing, is a touchy subject because of the risk of a false positive and then being forced to take very strong medications that can impact the unborn baby. Can you image the outrage if a woman received a false positive and was given AZT during pregnancy and then found out that she was in fact negative? Huge legal, medical, and ethical ramifications.

False positives are more frequent suring pregnancy for the SCREENING test aka the antibody test that is done as a first step. These tests are MEANT to catch every possible case so they have an inherent rate of false positives. Whenever a positive result comes up, it is automatically sent for confirmation, usually to a specialized public health lab, to get more specific and precise testing done. Those tests DO NOT have a high false positive rate. A woman would never be diagnosed with HIV from an initial screening test. Most people followed by a doctor would never even know that they had a false positive as the doctor would ALWAYS wait for confirmation. so yes, it would be outrageous if a pregnant woman was treated for HIV if she did not have it BUT IT DOES NOT EVER HAPPEN.

Quote:


Originally Posted by *RedPony* 
If I tell my HCP provider that there's NO CHANCE of me having HIV, why should I be tested? I haven't been (tested) during pregnancy nor have my babies. There's ZERO chance I've contracted HIV, which I didn't have to prove to my midwife, which is one of the millions of reasons I chose to have a homebirth. I'm glad I had this freedom and I think all women should have it.

I think that you have the right the refuse the test. However, that kind of attitude is just ignorant. I work at a fertility clinic and we have to test every patient whose reproductive material will be in our lab for the whole slew of STDs and other diseases. Most people who get positives are people who think they had zero chance.

In the past several years, it has been noticed that the groups that are getting more and more STDs are people considered low risk. Many doctors have focused their attention on people they considered high-risk and might have not offered testing for their middle-aged, married patients. Studies on this looked at chlamydia, gonorrhea and such but it would likely old true for other STDs as well.


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## MegBoz (Jul 8, 2008)

Quote:


Originally Posted by *elmh23* 
How do you know that there was no chance? Presumably you had sex to get pregnant, which is a way to contact HIV. While you trust your partner, they might be seeing someone on the side that you don't know about. This is one of the ways HIV is transmitted.

Ok, so should women be tested on a monthly basis then? Presumably, if they continue to be in a relationship, they'll have sex throughout the pregnancy & could contract it then.

How about Herpes? That can be trasmitted to the baby during birth, so should women be tested monthly for that as well?

Honestly, that is just ridiculous. If you're having sex with a partner, you MUST trust them. *You could be wrong, but you as the mother have the right to decide to get tested "just in case."* As another poster wrote, your HCPs could release you as a patient & decline to care for you if you refuse. But you still can't, and shouldn't be forced.

*No provider or anyone should make you feel paranoid & perpetuate a belief system that would shatter the foundations of marriage (if you're telling me I ought not to trust my husband, they you're endermining my whole marrige.)*

I got tested with my DS because I don't mind blood being drawn & they were doing it for other stuff anyway. I will refuse whenever we conceive #2. And if some HCP encouraged me to do so "just in case your DH has cheated" I would take offense to that.


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## Plummeting (Dec 2, 2004)

Quote:


Originally Posted by *soso-lynn* 
Most people followed by a doctor would never even know that they had a false positive as the doctor would ALWAYS wait for confirmation. so yes, it would be outrageous if a pregnant woman was treated for HIV if she did not have it BUT IT DOES NOT EVER HAPPEN.

I got a false positive on an HIV test about 11 years ago and I _did_ know it happened.







I'm glad policies are different now, and that experience didn't convince me to forego the test during this pregnancy or my other - although tbh I don't even know if they were doing it routinely 6 years ago; I just know I didn't decline - but it does make me very, very nervous about HIV tests in general.

At the same time as that test, I also got a false positive on a syphilis test (boy, that was a fun week) so it was explained to me as highly likely that both were related to an immune thing I had going on at the time. At any rate, I'm glad to know that they handle things a little better nowadays, by following up with further testing _before_ they scare the pants off of people.


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## Plummeting (Dec 2, 2004)

Quote:


Originally Posted by *MegBoz* 
How about Herpes? That can be trasmitted to the baby during birth, so should women be tested monthly for that as well?

Just as a practical matter, there's not really a reliable test to tell if the woman has contracted _genital_ herpes versus oral herpes or herpes gladiatorum (herpes elsewhere on the body). The only test for that would be swabs, but those would only detect genital herpes during active outbreaks or asymptomatic shedding, which doesn't happen every day or even most days. The risk of transmitting herpes to the baby in the absence of an outbreak is very low. A provider should notice most herpes lesions and in that case a c-section would be performed. In the absence of lesions, vaginal delivery is considered safe.


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## soso-lynn (Dec 11, 2007)

Quote:


Originally Posted by *MegBoz* 
Honestly, that is just ridiculous. If you're having sex with a partner, you MUST trust them. *You could be wrong, but you as the mother have the right to decide to get tested "just in case."* As another poster wrote, your HCPs could release you as a patient & decline to care for you if you refuse. But you still can't, and shouldn't be forced.

*No provider or anyone should make you feel paranoid & perpetuate a belief system that would shatter the foundations of marriage (if you're telling me I ought not to trust my husband, they you're endermining my whole marrige.)*


So, you are actually saying that it would be acceptable for a doctor or midwife to refuse care if someone did not want to get tested. I find that equally as horrible as a law requiring testing. What happened to informed consent. Doctors HAVE to treat people and give them the opportunity to make decisions on every aspect of their care. They canot just get rid of patients who disagree. I know it does happen in the US, but it is just so wrong.

If getting tested for HIV would shatter your marriage, then your marriage has a problem regardless. No one is telling you not to trust your husband, just not to put that blind trust above the health of your children. Perhaps we have different definitions of trust, but this just does not make any more sense than when I hear people saying gay marriage undermines their heterosexual marriage.


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## smeep (May 12, 2006)

I have so many problems with this, especially since pregnancy is listed as a "condition" that causes false positives. Sure, you could say just test again when baby is here, but in the meantime it's a high possibility that authorities (CPS, courts, etc.) could get involved and not allow mom to nurse. Just read some of the articles on MDC about it. It's quite scary.

I don't know if it was a law in Texas when I was pregnant 4 1/2 years ago, but my mw gave me the option. I didn't know much then so opted for it. In the future I will turn it down but be tested before I TTC.

Not to mention the whole testing process is a joke. There are two main forms of testing but they vary from tech to tech so one could say the same sample is + while another could say it's -.


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## KarlaC (Mar 20, 2009)

I'm not even sure why this is mandatory tbh unless there was an exposure to the hcp? The providers should be using universal precautions so there should not be a 'risk' of them catching it. It's not as if the hcp can force treatment on a patient nor should they be able to.

We don't require mandatory HIV testing for routine visits for any other condition.


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## frugalmama (Sep 12, 2009)

Quote:


Originally Posted by *KarlaC* 
I'm not even sure why this is mandatory tbh unless there was an exposure to the hcp? The providers should be using universal precautions so there should not be a 'risk' of them catching it. It's not as if the hcp can force treatment on a patient nor should they be able to.

We don't require mandatory HIV testing for routine visits for any other condition.

Actually in some areas they CAN legally force treatment for HIV {as well as TB}.

Public health issue.


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## LaffNowCryLater (May 2, 2003)

Doesn't bother me personally.


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## Materfamilias (Feb 22, 2008)

Quote:


Originally Posted by *MaterPrimaePuellae* 
The midwife told me this was the case in SC as well. The whole thing makes me pretty angry, too









Wow, is it? I don't remember having to be tested for this.


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## KarlaC (Mar 20, 2009)

Quote:


Originally Posted by *frugalmama* 
Actually in some areas they CAN legally force treatment for HIV {as well as TB}.

Public health issue.

Where is that at? Unless you're judged incompetent to make your own decisions I've never heard of forced HIV treatment in the states.


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## Kidzaplenty (Jun 17, 2006)

Why is "forced" HIV testing any different than all the other "forced" blood screenings that babies are put through (PKU+ screenings)? (Other than you can forgo it by having yourself tested before the birth.)

Seems to me it is the same thing. (Not that I agree with all the requirement of PKU screenings, but most MDC Moms so, so it would seem reasonable to chalk this one up to the same thing; the "best" interest of the baby.)

And though some statest allow certain exemptions on newborn screenings, not all do. Not to mention the over all concensus here that you should not exempt out because it could be harmful, even fatal, for the baby.


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## bjorker (Jul 25, 2005)

WOW, this is definitely NOT the law here in WA, and I'd be pretty angry if I was told that I am forced to do just about anything. Totally not okay.


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## Mountaingirl79 (Jul 12, 2008)

When I had my physical last year, they took a blood draw and didn't inform me that they were going to do an HIV test. They just said they were doing a couple other tests, like my blood count and whatever. They just told me afterwards that I was HIV negative. I wasn't even pregnant either!!! ( *altho I think it was because I went to the health dept..)
It did bother me. It's my blood, my body and what happens to it and in it is my business. I really don't see what the hype is still all about, people with HIV are living just as long and complete lives, in many cases, as those who don't have it. ( And I do know a couple of people who are HIV +)


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## elmh23 (Jul 1, 2004)

Quote:


Originally Posted by *MegBoz* 
Ok, so should women be tested on a monthly basis then? Presumably, if they continue to be in a relationship, they'll have sex throughout the pregnancy & could contract it then.

How about Herpes? That can be trasmitted to the baby during birth, so should women be tested monthly for that as well?

Honestly, that is just ridiculous. If you're having sex with a partner, you MUST trust them. *You could be wrong, but you as the mother have the right to decide to get tested "just in case."* As another poster wrote, your HCPs could release you as a patient & decline to care for you if you refuse. But you still can't, and shouldn't be forced.

*No provider or anyone should make you feel paranoid & perpetuate a belief system that would shatter the foundations of marriage (if you're telling me I ought not to trust my husband, they you're endermining my whole marrige.)*

I got tested with my DS because I don't mind blood being drawn & they were doing it for other stuff anyway. I will refuse whenever we conceive #2. And if some HCP encouraged me to do so "just in case your DH has cheated" I would take offense to that.

I trust my husband very much, but I still got HIV testing and chlamydia and gonorrhea testing at my first midwife appt. I have a friend who found out her husband cheated one week and the next found out she was pregnant. It was VERY MUCH a concern that he could have given her something (luckily he didn't.) And up until the moment she found out about his extra-marital affair, she trusted him 100%.

And actually, I don't care if people don't get the testing and I don't know if I agree with a law that makes it mandatory, I just wanted to point out that RedPony really doesn't have zero chance of being infected with HIV unless she had IVF done to get pregnant, because pretty much every other way requires you to have sex, thus giving you a chance that you could have acquired HIV.


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## Plummeting (Dec 2, 2004)

Quote:


Originally Posted by *KarlaC* 
I'm not even sure why this is mandatory tbh unless there was an exposure to the hcp? The providers should be using universal precautions so there should not be a 'risk' of them catching it. It's not as if the hcp can force treatment on a patient nor should they be able to.

We don't require mandatory HIV testing for routine visits for any other condition.

Because it's not to protect the hcp; it's to protect the *baby*.


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## RedPony (May 24, 2005)

Quote:


Originally Posted by *elmh23* 
How do you know that there was no chance? Presumably you had sex to get pregnant, which is a way to contact HIV. While you trust your partner, they might be seeing someone on the side that you don't know about. This is one of the ways HIV is transmitted.

Um. One partner for me. One partner for him. Ever. Thanks for the PSA on mistrust in marriage, tho. I'll take that into consideration.

Quote:


Originally Posted by *soso-lynn* 
I think that you have the right the refuse the test. *However, that kind of attitude is just ignorant.* I work at a fertility clinic and we have to test every patient whose reproductive material will be in our lab for the whole slew of STDs and other diseases. Most people who get positives are people who think they had zero chance.

In the past several years, it has been noticed that the groups that are getting more and more STDs are people considered low risk. Many doctors have focused their attention on people they considered high-risk and might have not offered testing for their middle-aged, married patients. Studies on this looked at chlamydia, gonorrhea and such but it would likely old true for other STDs as well.

Why is it that my view is any less valid then yours? Of course I have the right to refuse this test, so should everybody. That does not make me ignorant, however you want to color it, and I find it condescending that you'd say that. I'm not a fertility clinic patient, so your anecdote is just that...

(why do I bother?







)


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## mamabadger (Apr 21, 2006)

It may be true that nobody has absolutely zero chance of having HIV, but it is also impossible to have zero chance of a false positive result, with all that follows. It is a matter of weighing the risks, not choosing risk over no-risk.


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## soso-lynn (Dec 11, 2007)

Quote:


Originally Posted by *RedPony* 

Why is it that my view is any less valid then yours? Of course I have the right to refuse this test, so should everybody. That does not make me ignorant, however you want to color it, and I find it condescending that you'd say that. I'm not a fertility clinic patient, so your anecdote is just that...

My point was that magical thinking is ignorant, blind trust is ignorant and thinking that only a certain kind of people get HIV is ignorant. Do you really think that most people whose partners are cheating or doing drugs or whatnot know or are any different from you? If you feel so strongly that trust should substitute labwork, are you suggesting that people who believe they are not at risk should be able to give blood without getting tested?

Also, as I have said before, false positives do not have any horibble consequences because the tests that do give occasional false positives are SCREENING tests, not used to diagnose, but rather to find out if further testing is needed. The worst imaginable outcome in case of a false positive is if you need to provide a new sample and wait for results. In most cases anyway, even the initial positive result would appear as a possible false positive. If the cut-off for a postive is, say, 1.5, you would have a positive at 1,6. However, someone who truly has HIV would normally get a 40 or 50 on the same scale. So, even if a positive did come up, you usually have a pretty good idea even before the confirmation tests are done.

So, once again, NO ONE would EVER get any kind of treatment or diagnosis before confirmation tests clearly indicate a positive.

Seriously, it is almost 2010, I expect people to get over the 80s fear and stigma around HIV and start treating it like any other disease.


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## MegBoz (Jul 8, 2008)

Quote:


Originally Posted by *soso-lynn* 
So, you are actually saying that it would be acceptable for a doctor or midwife to refuse care if someone did not want to get tested. I find that equally as horrible as a law requiring testing.

No! I'm not saying I _personally_ find it "acceptable" for a HCP to refuse care. BUT... that is their choice!

I don't find it anywhere NEAR as horrible as a law requiring testing *because the law removes the mama's choice!* Removing choice is always bad, period.

So it is not a reasonable argument to justify the law requiring testing by saying: The law is there to protect the HCP. No! The HCP can protect themselves, if they want, but refusing care to un-tested Mamas. THAT is the solution. NOT an unconstitutional law that removes choice from mamas!
Does that make sense?

Quote:


Originally Posted by *soso-lynn* 
Doctors HAVE to treat people and give them the opportunity to make decisions on every aspect of their care. They canot just get rid of patients who disagree.

Actually, I could be wrong, by my understanding of 'patient abandonment' is this:
1. If a HCP wants to dismiss a patient, he must make sure she DOES have other care. (So he can't dump her till she gets into the care of another HCP)
2. He also can't dump her while she's in imminent need. i.e. He can't dump her while she's in active labor, until she is "stable" - defined as delivery of both baby & placenta

Since HIV testing is traditionally done during the 1st trimester, she's not in 'imminent need' so he totally could say, "OK, I'm giving you ample warning, get the test or you need to get care elsewhere." I do think that would be perfectly legal.

Quote:


Originally Posted by *soso-lynn* 
If getting tested for HIV would shatter your marriage, then your marriage has a problem regardless. No one is telling you not to trust your husband, just not to put that blind trust above the health of your children.









Ay yi yi! I did not say that getting an HIV test would shatter my marriage. I said, *"Telling me I ought not to trust my DH would undermine my marriage."*







Um, isn't it true that trust _is_ the foundation of marriage?

Besides, again, the HIV test is done during the 1st trimester. I would think most married couples have sex at least a few more times between the 1st trimester and delivery, so um, don't you STILL have to "just trust your DH not to cheat"?????


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## MegBoz (Jul 8, 2008)

Quote:


Originally Posted by *soso-lynn* 
My point was that magical thinking is ignorant, blind trust is ignorant and thinking that only a certain kind of people get HIV is ignorant.

Uh, you need to look into the definition of "Blind trust." Blind trust means you are blind - so you can't see- but you trust anyway. "Blind/can't see", means you aren't educated about the person/thing you are trusting. You don't really know about them, but you trust anyway.

I know my husband. I trust my husband. That isn't "blind" trust.

As a matter of fact, calling a woman's trust of her DH "Blind" trust is an ignorant statement.

My DH would realize he could jeopardize the health of me & the baby if he cheated. I trust him with our lives. If he cheated, he'd fess up & tell me so we could all get tested. *He would no more endanger the lives of his wife & child by keeping cheating a secret than he would endanger our lives by other actions*. I trust him not to do stupid, damaging things like smother the baby under a million blankets, or leave him alone in the bathtub. It's the same thing. I trust him with our lives.

**However I do agree with you that saying, "Only certain types of ppl get HIV is ignorant."

Quote:


Originally Posted by *soso-lynn* 
If you feel so strongly that trust should substitute labwork, are you suggesting that people who believe they are not at risk should be able to give blood without getting tested?

That analogy is totally nonsensical. I don't trust strangers, nor do I expect them to trust me. So OF COURSE I would expect a stranger to want MY blood tested before accepting a transfusion for me! Totally different scenario here. This analogy is not applicable at all. (Refer back to "blind trust" - taking blood donations from strangers _is_ "blind trust." I don't advocate blind trust.)

Quote:


Originally Posted by *soso-lynn* 
Seriously, it is almost 2010, I expect people to get over the 80s fear and stigma around HIV and start treating it like any other disease.

This isn't about fear & stigma. Again, do you think women should be screened _again_ late in pregnancy? What about those DH's' who are cheating _during_ the pregnancy? if you think we can't trust our partners, then why do you think a 1st trimester screening ONLY is sufficient? Do you see my point? How far do you think we should take this distrust? Don't we HAVE TO have some level of trust??


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## nikirj (Oct 1, 2002)

Wow, this is an interesting thread. Just to throw a few things out there:

Health care providers are supposed to follow "Universal Precautions," which basically means maintaining a level of self-protection that would prevent transmission of HIV (or Hep B or any number of infections) regardless of the woman's status. In theory your HCP has no grounds saying s/he is safer if you test. In practice, birth is messy and exposure is common...but that's no excuse. They are supposed to act the same whether you are positive or negative.

There have been studies done on paternity, where in a random population sample, just under 10% of the babies were not actually fathered by the person the mother named. Different studies say different things, but the true range seems to be around 5-10%. Compound this with male infidelity and you wind up with, at the very most conservative, 10% of the population having exposures they're not admitting. Health care providers have good reason to doubt fidelity. Yes, it's true, *most* couples are faithful. But in a large practice, if statistics hold true, you're going to run into at least a couple of people per year who are at risk and either don't know it or aren't admitting it.

In WA state the laws regarding HIV testing recently changed, and the way things are written has made it sound like providers can tag HIV testing on to prenatal panels without explicit consent (where it used to be that HIV testing had its own separate informed consent documentation and signature pages). All the MWs I know are still offering HIV testing specifically, but I can imagine a lot of docs offices are just putting HIV testing on their standard panels the way they do other less controversial tests.


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## Juniperberry (Apr 2, 2008)

I don't think it's mandatory over here, but I was offered a full blood test for everything, including HIV and many other diseases and I thought it was a good precaution. Not that I thought I had any reason to have anything, but you never know, and I didn't want to put myself, my baby or any others who are helping with my birth at unnecessary risk.

Turns out I'm negative for everything. I don't think it's a bad thing to test. And I think it's strange if testing creates any bad feelings in a relationship. If you're both loyal to each other then what's the problem?


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## MegBoz (Jul 8, 2008)

Quote:


Originally Posted by *Juniperberry* 
I don't think it's a bad thing to test.

I agree! It's legally-mandated testing I have a problem with.

Quote:


Originally Posted by *Juniperberry* 
And I think it's strange if testing creates any bad feelings in a relationship. If you're both loyal to each other then what's the problem?

Either of us getting tested isn't a problem.
The problem is in this hypothetical future discussion (whenever I conceive #2 & meet with the HB MW I've chosen.)

So my MW says, "Meg, you should get tested."

"Well, I did with DS, & I don't feel the need to be re-tested at this point now with baby #2."

"What, why?"

"Well, neither DH nor I have had sex with anyone else. & we certainly don't do IV drugs or engage in any other activities that could have made us contract HIV."

"But, Meg, _how do you KNOW your DH has been faithful?_"

"Uh, I trust him."

"Don't 'blindly' trust your DH! He could cheat & you wouldn't know."










It is these statements in red, which basically are the things soso-lynn has written on this thread, that would anger me. If I WERE to agree with the MW and think, "Gee, i CAN"T trust my DH!" than THAT would be damaging to the relationship.

It is not me getting tested that would damage the relationship.
It is not my MW suggesting I get tested that would damage the relationship.
It is *the MW suggesting I can not, and should not trust my DH that would damage a relationship.* (Well, it would 'damage' it _if I agreed with her_, which I would not.)

Now, if the MW just said, "I'm sure you are right, I'm sure your DH is a wonderful man, but I think it's always better to be safe than sorry. You're going to have blood drawn anyway so we might as well just test. It won't hurt anything."

Now THAT, THAT statement, I would say







"OK, sure, no problem!"

See the difference?

Compare & contrast the purple & red statements. *Telling women they can't/shouldn't trust their husbands/partners is not a good idea.* I would EXPECT that message to be met with resistance. it SHOULD be met with resistance because you DO need to trust your DH!


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## onlyboys (Feb 12, 2004)

In FL, at least, the statutory requirement for HIV testing does include an opt-out. The client must just state that they do not wish to have the test performed.

I'm not remotely opposed to the testing, by the way. The couple of times I've been stuck by a needle and/or splashed with fluid (VERY common at births) looking back at that lab result for HIV and HepB made me feel SO much better. It's just good information for your careprovider to have.


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## Kidzaplenty (Jun 17, 2006)

Quote:


Originally Posted by *MegBoz* 
I agree! It's legally-mandated testing I have a problem with.

But what is the difference between this test and all the other state mandated tests for newborns (with the distinction that you can choose to get this test instead of the baby)?

Or, do you have a problem with all the state mandated tests for newborns?


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## rayo de sol (Sep 28, 2006)

The states that require the pregnant mother to get the HIV test, force the test on the newborn if the mother refuses and then--if positive (and there's a high rate of false positives, not to mention that the newborn is merely showing the mother's antibodies, not its own, for the first 18 months of life)--force AZT drugs on the baby and don't allow the mother to breastfeed.

How do we fight this? How can we refuse testing for ourselves and for our babies?

I am enraged over this. It's like a nightmare.

Now, please be nice to me even if you disagree with the following. Each person is entitled to her opinion.

Quote:

There is no proof that HIV causes AIDS. In fact, all the epidemiological and microbiological evidence taken together conclusively demonstrates that HIV cannot cause AIDS or any other illness. The concept that AIDS is caused by a virus is not a fact, but a belief that was introduced at a 1984 press conference by Dr. Robert Gallo, a researcher employed by the National Institutes of Health (NIH). (14)
http://www.aliveandwell.org/


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## rayo de sol (Sep 28, 2006)

Interesting Mothering article that's very relevant to our current discussion:

Safe and Sound Underground: HIV-Positive Women Birthing Outside the System


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## Kidzaplenty (Jun 17, 2006)

Quote:


Originally Posted by *rayo de sol* 
The states that require the pregnant mother to get the HIV test, force the test on the newborn if the mother refuses and then--if positive (and there's a high rate of false positives, not to mention that the newborn is merely showing the mother's antibodies, not its own, for the first 18 months of life)--force AZT drugs on the baby and don't allow the mother to breastfeed.

How do we fight this? How can we refuse testing for ourselves and for our babies?

I am enraged over this. It's like a nightmare. [/url]

So, am I to assume that you are against PKU testing as well? Since it has similar required testing and results?


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## leila1213 (Sep 15, 2006)

Quote:


Originally Posted by *soso-lynn* 
...magical thinking is ignorant, blind trust is ignorant...

So, once again, NO ONE would EVER get any kind of treatment or diagnosis before confirmation tests clearly indicate a positive.

I think there is a difference between what RedPony is saying works for HER in terms of trusting her husband & making choices for HER babies' welfare, and saying that EVERYONE should be held to the same requirements, regardless of their own viewpoints (and constitutional liberties) on the subject. She is not thrusting her ideals or opinions on every pregnant woman & newborn in the country, only saying how she came to her own decisions/conclusions, kwim?

And although I don't think what she has said constitutes 'blind trust' or 'ignorance', making unqualified blanket statements about the validity of a test AND ITS APPLICATION IN REAL LIFE AS WELL AS ITS IMPACT ON REAL PEOPLE is really going too far. You can't know how EVERY provider is going to apply the testing/treatment standards with EVERY patient, nor how possible false positives could affect people & their families, any more (and I think quite a bit less) than RedPony could know with absolute certainty that her DH hasn't/wouldn't cheat on her. The difference being that the trust in one (her DH) only impacts her and her family, while the trust in the other (the test, the system, the HCPs) impacts MANY MANY MANY moms and babies.


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## noobmom (Jan 19, 2008)

The good thing about mandatory testing is that it takes the pressure of deciding to test off of the couple. Imagine this scenario: Husband and wife are at OB's office. Maybe the husband or the wife had a one-night stand somewhere along the way. "Do you want to test for HIV?" How could anyone answer anything, but no? In a perfect world, sure, people will be honest, but in a perfect world people don't cheat on their spouses either and we know that happens a lot. Who, exactly, would flag themselves as high-risk for HIV? Presumably people who engage in risky behavior are at least partially in denial.

I live in a state where the test is mandated. It doesn't bother me. I'm low-risk, but I absolutely would want to know if by some chance I had HIV while pregnant. It seems simple enough to avoid the test if you want to by having a home birth or foregoing prenatal care with a medical doctor. If you DO want to use an OB or other doctor for care, it fair enough that they would want to know your HIV status since it affects your care. Seems the same as knowing your blood type and whether you are Rh pos or neg.

Is treatment mandated as well? I would be more upset by that than just mandated testing.


----------



## MegBoz (Jul 8, 2008)

Quote:


Originally Posted by *noobmom* 
The good thing about mandatory testing is that it takes the pressure of deciding to test off of the couple. Imagine this scenario: Husband and wife are at OB's office. Maybe the husband or the wife had a one-night stand somewhere along the way. "Do you want to test for HIV?" How could anyone answer anything, but no?

This is easily rectified by the HCP (health care provider - healthy pregnant women, at least 80% of all pg moms, really should be in the care of a midwife, not an OB.)
anyway, this is easily rectified by the HCP simply saying, "I'm sure you're low risk and it's a one-in-a-million chance, but ya never know, and it's better to be safe than sorry. We'll be taking blood anyway for other tests, such as RH, so we might as well test for that too."

And there you have it, the HCP can take the pressure off the couple with a simple statement such as the above. *It isn't an issue that requires the law!*

Quote:


Originally Posted by *noobmom* 
I live in a state where the test is mandated. It doesn't bother me. I'm low-risk, but I absolutely would want to know if by some chance I had HIV while pregnant. It seems simple enough to avoid the test if you want to by having a home birth or foregoing prenatal care with a medical doctor.

Uh, so you advocate, essentially, I'm paraphrasing here, "The medical care you receive must be of a specific type. If you don't want that type of care, then you can just go underground, outside the system."
Nice! What a kind, compassionate view!

Quote:


Originally Posted by *noobmom* 
If you DO want to use an OB or other doctor for care, it fair enough that they would want to know your HIV status since it affects your care. Seems the same as knowing your blood type and whether you are Rh pos or neg.










I could be wrong, but I have the impression here that you think when a person goes to a doctor, the doctor treats the patient & tells her what to do, and it's her job to comply?
Whereas, the reality of it is that the HCP is a _service provider_ who *makes recommendations.* Whether or not to go along with those recommendations (i.e. "Do what the doctor says.") is the patient's choice.

The same would apply in the case of being Rh pos or negative. *It is the Mama's choice to get tested and to subsequently accept treatment if necessary based upon test results.* It is MAMA'S CHOICE here, not that the doctor needs to know so that HE can make the choice for her. See what I mean? Flip that on it's head.

A great example of this is testing for GBS. I know some women who refuse to be tested, although it is the "standard of care" and the CDC recommends testing and treatment for all + women. But it is still our choice. (I personally plan to be tested again whenever I have #2, but to refuse treatment if I"m positive, and only accept IV antibiotics _if_ I develop 2 or more risk factors (positive swab is only 1 "risk factor") - which, BTW, is how they manage it in the UK.

Quote:


Originally Posted by *noobmom* 
Is treatment mandated as well? I would be more upset by that than just mandated testing.

Check out the links for Mothering articles above. I don't believe treatment is mandated by law, _but,_ there is always that oh-so-fun issue of a call to Child Protective Services if you refuse - just like some of us wack-job crunchy mamas have dealt with for the horrific, endangering actions of having home birth, and refusing vaccinations and eye ointment at birth.


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## mediumcrunch (Dec 10, 2009)

Quote:


Originally Posted by *frugalmama* 
Law in TX here too - they tested me not once, not twice, but THREE times during my pregnancy and after the birth.

yup, they test at the initial prenatal visit and then in the second trimester and then again at the hospital. It's absurd.

I figure between 9 pregnancies and pre-marriage testing I have had no less than 15 HIV tests in the last 18 years. What an incredible waste of resources. And yes, I consent without a fight. It is not a battle I wish to pick.


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## soso-lynn (Dec 11, 2007)

Quote:


Originally Posted by *rayo de sol* 
The states that require the pregnant mother to get the HIV test, force the test on the newborn if the mother refuses and then--if positive (and there's a high rate of false positives, not to mention that the newborn is merely showing the mother's antibodies, not its own, for the first 18 months of life)--force AZT drugs on the baby and don't allow the mother to breastfeed.

Can you give any real life example where someone was treated for HIV after a false positive on a screening test? It just does not work that way. It is not a matter of individual doctors making decisions or anything like that, it is a matter of empirical testing in a lab.

Also, AZT was the drug of choice in the 90s but there now are many other drugs that are used in combination so the appropriate term is ART (anti-retroviral therapy).


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## rayo de sol (Sep 28, 2006)

Quote:


Originally Posted by *soso-lynn* 
Can you give any real life example where someone was treated for HIV after a false positive on a screening test?

Yeah, read the links that I posted above in my last post.

CPS will take your baby away from you to give it the drugs even if it tests a false positive, and they won't let you breastfeed.


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## Kidzaplenty (Jun 17, 2006)

But the same thing happens for the other newborn screenings (PKU and such), so again, are you against all manditory testing or only the HIV?


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## rayo de sol (Sep 28, 2006)

Quote:


Originally Posted by *Kidzaplenty* 
So, am I to assume that you are against PKU testing as well? Since it has similar required testing and results?

No.

I am only against mandatory HIV testing.

I am against mandatory HIV testing because of the extremely high rate of false positives that occur. The HIV test doesn't even test for the virus. It tests for common antibodies that are present in many conditions, one of the main ones being pregnancy.

The harm caused by false positives is appalling and is a human rights abuse.

Also, there is more and more doubt in the scientific community that HIV has anything to do with AIDS. AIDS is not caused by a virus; it's a condition of a lack of immune health that's brought on by many factors like poor nutrition. AIDS isn't even a specific disease. It's a collection of possible diseases, like tuberculosis, that includes a different list of diseases in every country. There's no unified, world-wide definition of what exactly AIDS is.

AIDS is not a contagious disease. At most, it's a state of poor health that should alert us to the fact that we can't go on abusing the environment and our bodies the way we have been. We did not evolve to thrive on the modern day foods that we currently subsist on.

Being "HIV positive" is not a death sentence. Don't start taking the pharmaceutical's drugs needlessly. And don't let them give those harmful drugs to your babies.


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## rayo de sol (Sep 28, 2006)

Quote:


Originally Posted by *Kidzaplenty* 
But the same thing happens for the other newborn screenings (PKU and such), so again, are you against all manditory testing or only the HIV?

Crosspost. See my response to your other post.

I am assuming (haven't gotten around to educating myself about PKU yet) that the PKU test is an accurate test that actually finds the truth. The same can't be said of the HIV test.

Therefore, I currently have no problem with the PKU test (an accurate test), but I have a lot of problems with the HIV test (which basically tests for common antibodies, not the virus itself).

Does the PKU test have a high rate of false positives like the HIV test does?


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## dinahx (Sep 17, 2005)

I'm sorry but there IS an inherent problem with testing Pregnant women for HIV and that is that you are taking away their right to be tested ANONYMOUSLY, a right that is granted to ALL other population groups. Tests during pregnancy are Confidential and there is a huge difference. You are taking away the right of a pregnant woman to direct her own health privacy and that is a huge violation. During my last pregnancy I was tested without my knowledge OR consent and the people at the lab knew my status before I did (negative but still!). During my second pregnancy I insisted on being tested anonymously before I would go 'on record' and the public health nurse tore me a new one! She was like 'what are you going to do if it is positive?' I was like 'have 5 freakin minutes alone with my PRIVATE health information?'. Also Anonymous testing offered to the general public is rapid result (15 minutes) while confidential testing mandated for pregnant women can take up to 2 weeks for the results. Again, lots of issues here.


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## rayo de sol (Sep 28, 2006)

Quote:


Originally Posted by *soso-lynn* 
Also, AZT was the drug of choice in the 90s but there now are many other drugs that are used in combination so the appropriate term is ART (anti-retroviral therapy).

Well, I don't keep up to date with the latest propaganda from the AIDS publicity machinery, but it doesn't really matter which drug they're forcing on newborns against the mother's will. It's heinous no matter which drug is currently in fashion.


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## noobmom (Jan 19, 2008)

Quote:


Originally Posted by *MegBoz* 
Uh, so you advocate, essentially, I'm paraphrasing here, "The medical care you receive must be of a specific type. *If you don't want that type of care, then you can just go underground, outside the system.*"
Nice! What a kind, compassionate view!

Well, that is kinda what I'm saying, although I would hope that it's not underground in the sense that it's illegal. You wouldn't go to a traditional Western doctor and when you're looking for a neuropathic remedy, would you? Or for an acupuncture treatment? No, of course not. Neither would you go to a chiropractor if you wanted a surgical treatment.

Quote:


Originally Posted by *MegBoz* 
I could be wrong, but I have the impression here that you think when a person goes to a doctor, the doctor treats the patient & tells her what to do, and it's her job to comply?

I'm sorry I gave you that impression--I certain don't have that kind of relationship with my doctors. They respect my wishes and if they don't, I find a new doctor, simple as that. However, I think people put doctors in a difficult position when they choose to withhold important information. Doctors are trained to make recommendations based on the information given. You are essentially asking them to "fly blind" if you refuse testing that is designed to allow them to make the best decisions possible. I don't think doctors should be allow to force you into testing or treatment, however, they can refuse to see you. Which bring you back to the above, being outside the system.

Quote:


Originally Posted by *MegBoz* 
Whereas, the reality of it is that the HCP is a _service provider_ who *makes recommendations.* Whether or not to go along with those recommendations (i.e. "Do what the doctor says.") is the patient's choice.

Again, that's fine, but people need to be prepared to hear, "I'm sorry then, you'll have to find someone else to treat you." I don't view my relationship with my doctor (particular one I see as frequently as an OB) in the one-sided way you do. In my mind, it's more of a partnership which requires some negotiation. A doctor's office is not a restaurant and the doctor is not my waiter. I don't get a menu and pick and choose what I want. I work with the doctor to come up with a plan that works for both of us. Both the patient and the doctor need to be within their comfort zones...and if those zone don't overlap, then it's a bad match.

Quote:


Originally Posted by *MegBoz* 
The same would apply in the case of being Rh pos or negative. *It is the Mama's choice to get tested and to subsequently accept treatment if necessary based upon test results.* It is MAMA'S CHOICE here, not that the doctor needs to know so that HE can make the choice for her. See what I mean? Flip that on it's head.

See, the thing is, I don't understand how you expect the doctor to make a recommendation without testing. Sure, the mom can accept or reject treatment, but how exactly does the doctor even know WHAT to recommend without knowing her status? No, the doctor doesn't make the choice, but by not testing, you've taken away a major piece of information. Do you understand why that would be frustrating and unfair (yes, unfair) to a doctor?

Again, I view treatment and testing quite differently.


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## dinahx (Sep 17, 2005)

When you go to a restaurant, the waiter doesn't call the police when you don't order the special.


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## mamabadger (Apr 21, 2006)

Quote:


Originally Posted by *noobmom* 
A doctor's office is not a restaurant and the doctor is not my waiter. I don't get a menu and pick and choose what I want. I work with the doctor to come up with a plan that works for both of us. Both the patient and the doctor need to be within their comfort zones...and if those zone don't overlap, then it's a bad match.


Quote:


Originally Posted by *dinahx* 
When you go to a restaurant, the waiter doesn't call the police when you don't order the special.

Yes, I could agree with Noobmom's point if it were not for the "police" thing. The doctor's power to enforce his recommendations, either on the pregnant woman or on her baby, changes the dynamic of the doctor/patient relationship completely.


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## soso-lynn (Dec 11, 2007)

Quote:


Originally Posted by *rayo de sol* 
Yeah, read the links that I posted above in my last post.

CPS will take your baby away from you to give it the drugs even if it tests a false positive, and they won't let you breastfeed.


Quote:


Originally Posted by *rayo de sol* 
No.

I am only against mandatory HIV testing.

I am against mandatory HIV testing because of the extremely high rate of false positives that occur. The HIV test doesn't even test for the virus. It tests for common antibodies that are present in many conditions, one of the main ones being pregnancy.

The harm caused by false positives is appalling and is a human rights abuse.

Also, there is more and more doubt in the scientific community that HIV has anything to do with AIDS. AIDS is not caused by a virus; it's a condition of a lack of immune health that's brought on by many factors like poor nutrition. AIDS isn't even a specific disease. It's a collection of possible diseases, like tuberculosis, that includes a different list of diseases in every country. There's no unified, world-wide definition of what exactly AIDS is.

AIDS is not a contagious disease. At most, it's a state of poor health that should alert us to the fact that we can't go on abusing the environment and our bodies the way we have been. We did not evolve to thrive on the modern day foods that we currently subsist on.

Being "HIV positive" is not a death sentence. Don't start taking the pharmaceutical's drugs needlessly. And don't let them give those harmful drugs to your babies.


Quote:


Originally Posted by *rayo de sol* 
Well, I don't keep up to date with the latest propaganda from the AIDS publicity machinery, but it doesn't really matter which drug they're forcing on newborns against the mother's will. It's heinous no matter which drug is currently in fashion.

I did not realize that you were one of those people who chose to ignore science and facts in favor of conspiracy theories. I guess there is no point debating this with you just like there is no point discussing any kind of science with a creationnist or any such denier of reality.

There is *absolutely no debate* in the scientific community on what causes AIDS and most tests for most infectious diseases are for antibodies. The actual rate of false positives for HIV tests (I mean with confirmation) is 1 in 250,000 and the vast majority of those cases have a known cause such as having partcipated in a vaccine trial or having multiple transfusions. Cases where a baby would be treated after a false positive would be if the mother was not tested during her pregnancy and only tested at the birth. At that time, there is no time to wait for confirmation since immediate treatment can literally save the baby's life.


----------



## mamabadger (Apr 21, 2006)

Quote:


Originally Posted by *soso-lynn* 
The actual rate of false positives for HIV tests (I mean with confirmation) is 1 in 250,000...

I assume this is correct, but I have never been able to find an explanation of how the rate of false positives could be determined. When would you decide a positive test result had been false? Or is the 1 in 250,000 a theoretical estimate?


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## lovebug (Nov 2, 2004)

lots of good points in this thread!

i am going to have to read up on all the posts...

i am on the fence on this one... i will just peek in


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## MegBoz (Jul 8, 2008)

Quote:


Originally Posted by *noobmom* 
Well, that is kinda what I'm saying, although I would hope that it's not underground in the sense that it's illegal. You wouldn't go to a traditional Western doctor and when you're looking for a neuropathic remedy, would you? Or for an acupuncture treatment? No, of course not. Neither would you go to a chiropractor if you wanted a surgical treatment

Well, first off, choosing HB does end up being somewhat illegal in many states. Here in Maryland, direct entry midwifery, "CPMs", are illegal. It's not illegal for the couple to use their services, but it is illegal for them to "practice medicine without a license."

Second, HB MWs and FSBC are scarce in the US. Many women have no options but hospitals or UC.

& finally, some women truly NEED the care of an OB! High-risk for whatever reason, needing a CS for complete placenta previa, etc. So they may NEED or even WANT some degree of medical care, but do NOT want the whole package. Again, it is wrong & unreasonable to say, "If you want/need a hospital birth, you MUST conform to EVERYTHING they 'advise.'" It's wrong, just plain wrong.

Quote:


Originally Posted by *noobmom* 
However, I think people put doctors in a difficult position when they choose to withhold important information. Doctors are trained to make recommendations based on the information given. You are essentially asking them to "fly blind" if you refuse testing that is designed to allow them to make the best decisions possible.

I see what you are saying here & I agree with the concept. For example, if someone wanted an OB or MW to NEVER listen to the baby's heart beat (during prenatal visits as well as in labor & delivery), that would be so extreme that it would be more than fair for that HCP to say, "Well then I can't have you as a client."

But I don't think HIV testing crosses that threshold personally.

In my above example, fetal HR is a _crucial_ indicator that a maternity HCP needs in order to make decisions & recommendations related to maternity care.

But even if a PG mom IS HIV+, she can refuse to treat the HIV. In which case, the maternity HCP would continue _maternity_ care just as normal. After all, can't people live healthy lives while being HIV+? So the HCP should treat the PG mama based on any symptoms she does show.
My point being, if an HIV+ Mama were to refuse treatment of HIV, it wouldn't impact how the pregnancy & birth are cared for anyway. So it is NOT a "flying blind" issue.

Besides, as I've said, I personally will refuse it with #2 (Unless my MW really wants me to, then I'll cave, It's not that big of a deal.) But *I would initially refuse because I know it's pointless*... because I trust my DH with my life and the lives of our children. So I know he would tell me if I should get re-tested. (I had the test with baby #1 already.)


----------



## MegBoz (Jul 8, 2008)

Quote:


Originally Posted by *Kidzaplenty* 
But the same thing happens for the other newborn screenings (PKU and such), so again, are you against all manditory testing or only the HIV?

This Q was asked of me too & I haven't answered it. I don't really have an opinion on these.
I think it's comparing apples to oranges in a way. One is mandatory testing of ADULTS, the other mandatory screenings of CHILDREN.

The thing is, legal precedents already exist stating that the law cannot force an adult to undergo any medical treatment or procedure for the benefit of their child. (Yes, you could have the old "calling CPS" issue), but a mama can't be legally forced to do something to her own body in order to benefit her child - such as donate a kidney.

To put it more succinctly, being a parent, as well as a PG women, doesn't legally compel you to sacrifice your own bodily autonomy & right to independently make your own health care decisions.

The government being involved in the welfare of children by legally mandating newborn screenings, well, that is a separate issue.


----------



## MegBoz (Jul 8, 2008)

Quote:


Originally Posted by *noobmom* 
Sure, the mom can accept or reject treatment, but how exactly does the doctor even know WHAT to recommend without knowing her status? No, the doctor doesn't make the choice, but by not testing, you've taken away a major piece of information. Do you understand why that would be frustrating and unfair (yes, unfair) to a doctor?

Again, *I view treatment and testing quite differently.*

Bolding mine.
I just realized, if you agree with me that the woman has a right to decline any treatment for HIV, then why do you disagree with my argument that the woman should have the right to decide whether to get tested in the first place?? That doesn't make sense!

If she knows she doesn't want treatment anyway, why would she get tested?


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## dinahx (Sep 17, 2005)

How is this about Creationism vs. Darwinism at all?


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## MegBoz (Jul 8, 2008)

Quote:


Originally Posted by *dinahx* 
Whoa, SosoLyn, how many slurs can you work into one post. How is this about Creationism vs. Darwinism at all?

Well, clearly I'm not soso-lynn, but what she wrote is:

Quote:


Originally Posted by *soso-lynn* 
I did not realize that you were one of those people who chose to ignore science and facts in favor of conspiracy theories. I guess there is no point debating this with you just like there is no point discussing any kind of science with a creationnist or any such denier of reality.

I think it's pretty clear, she is saying that a creationist is someone who denies reality & ignores science. Therefore, there is no point debating with them (because they will ignore facts in favor of holding on to a belief that is contrary to science & contrary to facts.)

I don't see how that is a "slur." It is a fact that (specifically) young-earth/ anti-Darwinism creationists DO choose to ignore science. That's the truth of the matter. No slur there.


----------



## Kidzaplenty (Jun 17, 2006)

Quote:


Originally Posted by *MegBoz* 
This Q was asked of me too & I haven't answered it. I don't really have an opinion on these.
I think it's comparing apples to oranges in a way. One is mandatory testing of ADULTS, the other mandatory screenings of CHILDREN.

It is not really different, because if the mother chooses not to be tested, they will test the child. So, it IS a mandatory screening of children with the only difference that the mother can choose to test herself before hand rather than have the child tested at birth.


----------



## Pirogi (Apr 5, 2007)

Quote:


Originally Posted by *MegBoz* 
I don't see how that is a "slur." It is a fact that (specifically) young-earth/ anti-Darwinism creationists DO choose to ignore science. That's the truth of the matter. No slur there.

My dictionary defines "slur" as:

Quote:

to cast aspersions on; calumniate; disparage; depreciate

Quote:


Originally Posted by *soso-lynn* 
I did not realize that you were *one of those people who chose to ignore science and facts in favor of conspiracy theories.* I guess there is no point debating this with you just like there is no point discussing any kind of science with a creationnist *or any such denier of reality.*

(bolding mine)

soso-lynn's remarks were quite inflammatory IMHO. Not everyone is enamoured with our Western idolization of science and technology. There are those of use who question the establishment's (including the scientific community) methods, materials, and world view. That doesn't make us ignorant and shouldn't make us target for derision. Your (general) reality isn't necessarily the right version and certainly isn't the only version. How is an attitude like the one displayed above any different from the attitude of an OB who derides a mother for choosing to VBAC, when the science he believes clearly tells him that it is a dangerous and irresponsible thing to do? We all have different comfort and acceptance levels of studies and recommendations. The sheer amount of funding available for AIDS research gives me pause, and I personally feel that these laws mandating testing are reflections of the $$$ invested in AIDS in the US and worldwide.

I also liken the impact that the high false-positive rate will have on a woman's pregnancy to the parallel discussion WRT prenatal screening. Buckley's _Gentle Birth, Gentle Mothering_ has an excellent chapter discussing this. How will a false positive change a mother's perception of her health, her body, her baby, her future? Should we be subjecting pregnant women to that kind of stress and disruption during her pregnancy? What is the emotional and psychological cost and to how many women and babies, and is that cost worth it to possibly find and treat a few HIV-positive babies? How many HIV-positive babies would actually benefit from this policy? What are the broader implications this holds for American women's ability to refuse standard care and treatment? For the US government's power over the physical bodies of its citizens?


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## soso-lynn (Dec 11, 2007)

Quote:


Originally Posted by *mamabadger* 
I assume this is correct, but I have never been able to find an explanation of how the rate of false positives could be determined. When would you decide a positive test result had been false? Or is the 1 in 250,000 a theoretical estimate?

Once someone is diagnosed, further tests such as a viral load are done and everything is correlated with clinical information. The rate of false positives is an actual figure. Since the vast majority of true false positives have a known cause, it is somewhat easy to identify them.

Quote:


Originally Posted by *MegBoz* 
But even if a PG mom IS HIV+, she can refuse to treat the HIV. In which case, the maternity HCP would continue _maternity_ care just as normal. After all, can't people live healthy lives while being HIV+? So the HCP should treat the PG mama based on any symptoms she does show.
My point being, if an HIV+ Mama were to refuse treatment of HIV, it wouldn't impact how the pregnancy & birth are cared for anyway. So it is NOT a "flying blind" issue.

Maternity and immediate post-partum care would be drastically altered. The kind of birth will have an impact on transmission rates as well as the medication given to the mother and/or the child. Even if a mother refuses ARTs, there are still ways to minimize the risks of transmission. I personnally think that this is a case where the argument to force treatment could have some grounds to be made (I am not saying it should just that a compelling case can be made). If someone who knows they have HIV has unprotected sex and fails to notify their partners, they can go to jail. Why would we accept that a mother could willingly pass HIV to her child when it can easily be avoided?

Quote:


Originally Posted by *dinahx* 
How is this about Creationism vs. Darwinism at all?


Quote:


Originally Posted by *MegBoz* 
Well, clearly I'm not soso-lynn, but what she wrote is:

I think it's pretty clear, she is saying that a creationist is someone who denies reality & ignores science. Therefore, there is no point debating with them (because they will ignore facts in favor of holding on to a belief that is contrary to science & contrary to facts.)

I don't see how that is a "slur." It is a fact that (specifically) young-earth/ anti-Darwinism creationists DO choose to ignore science. That's the truth of the matter. No slur there.


Quote:


Originally Posted by *Pirogi* 
My dictionary defines "slur" as:

(bolding mine)

soso-lynn's remarks were quite inflammatory IMHO. Not everyone is enamoured with our Western idolization of science and technology. There are those of use who question the establishment's (including the scientific community) methods, materials, and world view. That doesn't make us ignorant and shouldn't make us target for derision. Your (general) reality isn't necessarily the right version and certainly isn't the only version. How is an attitude like the one displayed above any different from the attitude of an OB who derides a mother for choosing to VBAC, when the science he believes clearly tells him that it is a dangerous and irresponsible thing to do? We all have different comfort and acceptance levels of studies and recommendations. The sheer amount of funding available for AIDS research gives me pause, and I personally feel that these laws mandating testing are reflections of the $$$ invested in AIDS in the US and worldwide.

I also liken the impact that the high false-positive rate will have on a woman's pregnancy to the parallel discussion WRT prenatal screening. Buckley's _Gentle Birth, Gentle Mothering_ has an excellent chapter discussing this. How will a false positive change a mother's perception of her health, her body, her baby, her future? Should we be subjecting pregnant women to that kind of stress and disruption during her pregnancy? What is the emotional and psychological cost and to how many women and babies, and is that cost worth it to possibly find and treat a few HIV-positive babies? How many HIV-positive babies would actually benefit from this policy? What are the broader implications this holds for American women's ability to refuse standard care and treatment? For the US government's power over the physical bodies of its citizens?

I think MegBoz explained it correctly. If you choose to say that Earth was created 10000 years ago or that HIV does not cause AIDS or that global warming is not real, you are in fact ignoring science. You are free to say that you prefer religion or whatever else you base your ideas on but the fact still remains that you are ignoring reality and facts and that no coherent debate can happen.

There is also a major difference between thinking critically about scientific methologies and biases in research and denying facts.

Also, testing for HIV cannot be compared to prenatal testing for genetic abnormalities. The purpose of one of those is to prevent transmission of an infectious disease and the other is to benefit the parent in terms of choosing how to handle the pregnancy.

And, ONCE AGAIN, false positives are only a noteworthy issue with ELISA antibody tests which, on their own, do not diagnose HIV. HIV is diagnosed by repetively positive ELISAs and a positive WB test. In addition to that, other further testing can be done to type the virus RNA and calculated the viral load. Fear of false positives, although clearly unfounded, should therefore be an argument for testing early in pregnancy to have time to get further testing and have a definite result before it is time to make decisions about appropriate care.

In my city, the local HIV pregnancy clinic that treats pregnant women with HIV, there has been zero cases of maternal transmission in the past decade. Without that kind of care (which includes striving for natural childbirth in most cases, the exception being women with an extremely high viral load), the rate would be at least 1 in 4. I just don't understand how people can choose to not get a simple test that can make such a difference in fetal outcomes.


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## mamabadger (Apr 21, 2006)

Quote:


Originally Posted by *soso-lynn* 
Once someone is diagnosed, further tests such as a viral load are done and everything is correlated with clinical information. The rate of false positives is an actual figure. Since the vast majority of true false positives have a known cause, it is somewhat easy to identify them.

Okay - I realize I am going to sound stupid, but I really can't find the explanation I am looking for anywhere, so please bear with me.
One test is confirmed by further tests. I get that. But how do you know that the further tests are accurate, and not giving a false positive? With other diseases, there might be obvious symptoms within a short period of time. Someone with a positive HIV test, on the other hand, might appear perfectly healthy in every way, and might continue to appear healthy for years. Does every person who tests HIV positive, except 1 in 250,000, develop AIDS symptoms in a predictable length of time? And if so, how do you distinguish AIDS symptoms from side effects of AIDS drugs, since I understand there is a great deal of overlap?
Maybe I am missing something obvious, but these are the concerns that would make me hesitate to accept an HIV test.


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## Pirogi (Apr 5, 2007)

Quote:


Originally Posted by *soso-lynn* 
I think MegBoz explained it correctly. If you choose to say that Earth was created 10000 years ago or that HIV does not cause AIDS or that global warming is not real, you are in fact ignoring science. You are free to say that you prefer religion or whatever else you base your ideas on but the fact still remains that you are ignoring reality and facts and that no coherent debate can happen.

There is also a major difference between thinking critically about scientific methologies and biases in research and denying facts.

There is data by respected scientific researchers that indicates that global warming is NOT real. I don't want to derail this thread any further by bringing in the global warming debate, but the point at which theory becomes fact is quite blurred. You may believe these things to be absolute truth, and that is completely fine. What is NOT completely fine is your stubborn and elitist insistence that those who view the world differently are ignorant of the "facts." Science is changeable. This isn't a new problem. Remember when the earth was flat?

Quote:


Originally Posted by *soso-lynn* 
And, ONCE AGAIN, false positives are only a noteworthy issue with ELISA antibody tests which, on their own, do not diagnose HIV. HIV is diagnosed by repetively positive ELISAs and a positive WB test. In addition to that, other further testing can be done to type the virus RNA and calculated the viral load. Fear of false positives, although clearly unfounded, should therefore be an argument for testing early in pregnancy to have time to get further testing and have a definite result before it is time to make decisions about appropriate care.

Not sure how the fear of false positives is unfounded? They DO happen, frequently, with ELISA. My point is not that the vast majority of these false positives wouldn't be corrected with further testing. It is that, once a pregnant woman hears such crushing news in the middle of her pregnancy, you can't undo the damage that causes. "Oops, the test was wrong" doesn't help the agonizing weeks, the fear, the stress, the planning, the crying, the anguish. And the subsequent effects these things would have on her unborn baby. A pregnant woman who chooses not to subject herself to testing should be allowed that choice.


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## soso-lynn (Dec 11, 2007)

Quote:


Originally Posted by *mamabadger* 
Okay - I realize I am going to sound stupid, but I really can't find the explanation I am looking for anywhere, so please bear with me.
One test is confirmed by further tests. I get that. But how do you know that the further tests are accurate, and not giving a false positive? With other diseases, there might be obvious symptoms within a short period of time. Someone with a positive HIV test, on the other hand, might appear perfectly healthy in every way, and might continue to appear healthy for years. Does every person who tests HIV positive, except 1 in 250,000, develop AIDS symptoms in a predictable length of time? And if so, how do you distinguish AIDS symptoms from side effects of AIDS drugs, since I understand there is a great deal of overlap?
Maybe I am missing something obvious, but these are the concerns that would make me hesitate to accept an HIV test.

A false positive on a viral load is not possible as they actually look for copies of the virus. Only false negatives could occur with that test since the viral load can be so low as to be undetectable. If there is any doubt that the test may be a false positive, a PCR test and a repeat of the previous tests with a new sample would be done. In those cases, the western blot may be positive but lacking a response to certain antigens that make it uncertain. The lab report would normally explain that.

Alos, it is important to understand that drugs are not necessarily started the second someone gets a confirmed positive. A more complete health analysis is done and consultations with specialists are necessary to determine a proper drug course, if they are needed right away. In the case of a pregnant woman, those decisions are not taken lightly given that drugs do have a certain toxicity. In the case of someone who has an undetectable viral load (as it would be for a false positive), treatment would be much more conservative and tests would be repeated several times, providing there was time to make such decisions (the third trimester is when the drugs are important).

I assume it is theoretically possible for someone to get a true false positive that would only be proven negative after treatment was begun (probably more common in developing countries where there is not as much access to follow up testing and medication would be started as soon as possible if available at all). Those instances would have to be extremely rare though, not even statiscally significant. You also need to keep in mind that, once again providing there is no huge rush such as a positive test right before delivery and such, HIV specialists tend to be very thorough and not stuck in the 80s panic and fear about HIV. If you take the worst-case scenario and think about what would happen if you had a true false positive, you can definitely be assured that clinical information (risk factors, behaviour, etc) would also be taken into consideration and no one would just run to the courts to force medicine on you.

You can probably ask your HCP what their procedure would be in the event of a positive result and have that discussion in advance. You might see that there is a great system in place and be a lot more comfortable. Alternatively, you might realize that your HCP is completely ignorant and insensitive (sadly many still are but remember that your OB/midwife would not be in charge of your HIV treatment or further diagnosis if required). In that case, it might be a good idea to switch providers and find someone better.

I do think that the main reason why HIV is such a scary test to have is due to the stigma and fear attached to it from the beginning of the pandemic. For instance, most people will get tested for hepatitis B and C (who, by the way, are much more complicated to diagnose accurately) without being so worried about false positives and whether or not they are at risk. That kind of attitude is not only detrimental to proper care of those infected, it also is a great perpetuator of racism and other social discrimination. I think that the easiest way to overcome that and stop the social devastation caused by HIV is to start viewing it as any other infectious disease and not as something special or different. It is really ridiculous that we are at the point where some legislations feel the need to make it mandatory. Most of those laws actually come from the point of view that making it compulsory alleviates the burden on patients of having to fully disclose their lifestyle or be afraid that asumptions will be made about them if they choose to get it done. For example, there is no need to make testing for rh sensitization required by law since no stigma is attached to a positive result.

Quote:


Originally Posted by *Pirogi* 

Not sure how the fear of false positives is unfounded? They DO happen, frequently, with ELISA. My point is not that the vast majority of these false positives wouldn't be corrected with further testing. It is that, once a pregnant woman hears such crushing news in the middle of her pregnancy, you can't undo the damage that causes. "Oops, the test was wrong" doesn't help the agonizing weeks, the fear, the stress, the planning, the crying, the anguish. And the subsequent effects these things would have on her unborn baby. A pregnant woman who chooses not to subject herself to testing should be allowed that choice.

Once again, ELISA alone is a SCREENING test so yes, it is DESIGNED to have a certain rate of false positive in order to minimize false negatives. That is the purpose of a screening test. Unless her HCP does not know how to read lab reports, a diagnosis of HIV would absolutely never be given after an initial positive ELISA. Normal procedure is to not even mention it to the patient. The only case where it would be mentionned to the patient is if a new sample is needed for confirmation testing which is rarely the case. In that situation, the patient would be told that the test is not yet conslusive. In the vast majority of cases the sample would be retested and the WB would be done before the ordering physician even got a report. Also, in most cases of false positive ELISAs, the result would be a very low number. Say the threshold for positive is 1.5, the result might be a 1.7 or a 2 while a true positive would likely be a 40 or 50. That information would also be given if repeat testing was needed.

As I said before, the easy solution to that is to either get tested on a regular basis before or during any attempts to conceive and to have a discussion with the HCP regarding their exact protocol for handling results. It is perfectly reasonnable to expect your HCP to have up to date information on HIV and its testing methods and get assurance in advance that any positive ELISA result would be handled according to science and not ignorant HCP panic.

I absolutely do agree that informed consent should always be the basis of any HCP/patient interaction and that things such as the emotional impact of delayed results and such should be taken into consideration (this is where a parallel can be drawn with prenatal genetic testing). However, I do not think that the solution is to not get tested but rather to improve HCP's knowledge and manner of conveying information as well as improving available information and consent procedures for patients and getting rid of the special stigma ascribed to certain diseases.

When people start equating getting tested for certain diseases with the level of trust in their marriage and other things of the sort, we end up with simple things reaching irrational levels of complication such as laws forcing things on patients.


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## Kidzaplenty (Jun 17, 2006)

Quote:


Originally Posted by *Pirogi* 
It is that, once a pregnant woman hears such crushing news in the middle of her pregnancy, you can't undo the damage that causes. "Oops, the test was wrong" doesn't help the agonizing weeks, the fear, the stress, the planning, the crying, the anguish. And the subsequent effects these things would have on her unborn baby.

First, I supose this _could_ happen, but I would think, as in my case, where I truly believed I had about a zero chance of ever being infected, that I would more likely disregard any "positive" as a false positive until such a time I had further testing to back it up. No worries or stress or crushing news. And if I _did_ end up with a true positive, I would be very happy to just _know_ so I could deal with it.

But, perhaps I am just different than anyone else.

Quote:

A pregnant woman who chooses not to subject herself to testing should be allowed that choice.
As far as I know, a pg woman _can_ choose not to subject herself to such testing. However, the consequence of such a choice is having the baby tested once it is born.

I would think, in the benefit of the baby, it would be better to have the mom tested rather than the baby (even if it does lead to stress for a bit prior to birth).


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## Pirogi (Apr 5, 2007)

Quote:


Originally Posted by *Kidzaplenty* 
As far as I know, a pg woman _can_ choose not to subject herself to such testing. However, the consequence of such a choice is having the baby tested once it is born.

I would think, in the benefit of the baby, it would be better to have the mom tested rather than the baby (even if it does lead to stress for a bit prior to birth).

And so would probably nearly every pregnant woman agree with you. And so there is no real choice there. And no one should be forced to choose between unwanted tests and procedures for themselves vs unwanted tests and procedures for their baby. This is a basic human right and bodily integrity issue for me. I don't want any other person or government telling me what to do with my body, or with my baby's body. And it is certainly inappropriate to pit one against the other.


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## Kidzaplenty (Jun 17, 2006)

While I agree with you, I don't think that it is really any different than the PKU+ tests that a majority of MDC is all in favor of. Which I find just as much an intrusion on my basic (and my baby's) human rights. That is why I asked.

I can't see someone arguing that the PKU is a "good" thing and _should_ be required "for the benefit of the baby" and arguing against the HIV testing. To me, they are exactly the same thing.


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## noobmom (Jan 19, 2008)

Quote:


Originally Posted by *MegBoz* 
Again, it is wrong & unreasonable to say, "If you want/need a hospital birth, you MUST conform to EVERYTHING they 'advise.'" It's wrong, just plain wrong.

Agreeing that a HIV test can be mandated does not mean I think that a pregnant woman needs to agree to everything. It's one test.

Quote:


Originally Posted by *MegBoz* 
Bolding mine.
I just realized, if you agree with me that the woman has a right to decline any treatment for HIV, then why do you disagree with my argument that the woman should have the right to decide whether to get tested in the first place?? That doesn't make sense!

If she knows she doesn't want treatment anyway, why would she get tested?

I see treatment as something you're subjected to--it alters your body and can have many side effects. Getting tested (at least in the case of a blood test) is much less physically intrusive. And in the case of a pregnant woman who is willing to give birth with a OB/in a hospital, it's almost guaranteed that you will have blood drawn at some point for some other reason anyway.

Again, she would get tested in order to provide the most accurate medical profile possible to her HCPs, so that they can make the best recommendations that they are trained to make.

Some PPs have brought up the fact that this debate seems very centered on the fact that it's specifically HIV, when there are many other tests that are mandated for pregnant women/newborns. I agree that it's due to the stigma that goes along with being infected with HIV--and perhaps that is why I am not up-in-arms about mandated HIV testing. It's time we moved away from fear that surrounds HIV and treat it like the medical disease that is it--without any moral judgments.

Interestingly enough, the CDC recommends opt-out testing for pregnant women. In other words, testing is done by default, but you can opt-out.

http://www.cdc.gov/mmwr/preview/mmwr...cid=rr5514a1_e

However, they also seem to advocate screening of newborns (no mention of an opt-out) if the mother delivers with an unknown HIV status.

I think this is a very interesting thread and I hope it doesn't get derailed!


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## soso-lynn (Dec 11, 2007)

Quote:


Originally Posted by *noobmom* 

Interestingly enough, the CDC recommends opt-out testing for pregnant women. In other words, testing is done by default, but you can opt-out.

http://www.cdc.gov/mmwr/preview/mmwr...cid=rr5514a1_e

However, they also seem to advocate screening of newborns (no mention of an opt-out) if the mother delivers with an unknown HIV status.


This issue of testing mandated by law with possible legal reprisal is very specific to American health care and culture. In all other countries, the debate as always been between an opt-in system and an opt-out system. Most countries have adopted an opt-out system. It is nowhere but in the US a legal issue. The same applies to any other test for mother and/or baby as well as vaccination and such. No law in Canada could ever force anyone to vaccinate their children or even have to apply for any religious exemption. Culturally, it just does not make sense. It is actually kind of ironic that a country that emphasizes so much personal freedom and is weary of any government interference ends up with such Orwellian situations.

It would be interesting, if anyone has this info handy, to get a list of states that legally require HIV testing and to have the specific text of those laws.


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## Pirogi (Apr 5, 2007)

Quote:


Originally Posted by *Kidzaplenty* 
While I agree with you, I don't think that it is really any different than the PKU+ tests that a majority of MDC is all in favor of. Which I find just as much an intrusion on my basic (and my baby's) human rights. That is why I asked.

I can't see someone arguing that the PKU is a "good" thing and _should_ be required "for the benefit of the baby" and arguing against the HIV testing. To me, they are exactly the same thing.

The issue is the same IMO also. I believe women should have the choice to opt out of metabolic testing if they desire.

Totally agree on the Orwellian irony. I think a large part of it is the for-profit medical system in place here. I don't believe for a second that most lawmakers know everything, or even much, about the intricacies of the laws they pass. Other people do the thinking, pass on recommendations, and then there is a cursory review before voting. Our government depends on "expert" opinion to make policy. Doctors are presumed to be medical experts, highly influenced by pharmaceutical companies and other healthcare enterprises. I am against public health care because I don't believe the power shift would occur that is necessary to create reform. I think the same players would still have power, but now there would be the force of law and punitive threat behind their agendas.


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## Pinoikoi (Oct 30, 2003)

I was tested with several of my pregnancies. In our State, though, the test is encouraged but not required. I declined it this time.

I can just imagine my health insurance adjustor looking at my paperwork and thinking, "she's getting an HIV test again? What is she DOING?"

I don't need anyone thinking I am a bigger health risk than I really am.

If I want a test in the future, I will pay out of pocket- but I definitely won't be forced.

I wonder if the "mandates" are in response to insurance questions.. for example, if I lived in a State where testing was required with each pregnancy I guess the insurance companies would be used to seeing the repeated tests and wouldn't question it?


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## soso-lynn (Dec 11, 2007)

Quote:


Originally Posted by *Pinoikoi* 
I wonder if the "mandates" are in response to insurance questions.. for example, if I lived in a State where testing was required with each pregnancy I guess the insurance companies would be used to seeing the repeated tests and wouldn't question it?

Yes, a huge part of it has to do with money. If a test is required by law then it must be paid for. Also, there was a time when insurance companies and such (even employers) would actually assume that someone getting an HIV test is either engaging in homosexual sex or doing drugs and people would loose coverage, jobs and be "outed" for it. That is why anonymous testing centers were created. One of the motivations for some of those laws may well have been to stop that attitude and allow for people to be tested without fear of people make assumptions about them. That is why, while I do oppose theoretically any legal mandate for any test, I do think that the intentions behind such legislation are not to be able to control people's bodies and their lives but rather to make it easier and lessen the stigma.

In a public health care system, there are no insurance companies involved and those issues are a lot less relevant. Actually, I have noticed that here in Canada, if someone refuses the test, that is when people get a bit suspicious and HCPs might have a lenghtier discussion about it.


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## rayo de sol (Sep 28, 2006)

Quote:


Originally Posted by *soso-lynn* 
I did not realize that you were one of those people who chose to ignore science and facts in favor of conspiracy theories. I guess there is no point debating this with you just like there is no point discussing any kind of science with a creationnist or any such denier of reality.

You can't lump me into your neat little categories.

I am a left-wing, atheist intellectual with a bachelor's degree, and I adore science--and Darwin, for that matter.

I doubt that the creationists would want to hang out with me.


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## rayo de sol (Sep 28, 2006)

Quote:


Originally Posted by *soso-lynn* 
There is *absolutely no debate* in the scientific community on what causes AIDS and most tests for most infectious diseases are for antibodies.

Yes, there is. It's just that the scientists who disagree with the sacred cow AIDS propaganda are censored and ostracized and lose their jobs.

Luc Montagnier, the French scientist who discovered HIV (even though Gallo stole all the credit), does not believe that HIV causes AIDS, although he hasn't always been forthright with his opinion, probably because it's professional suicide to do so.

Quote:

Montagnier states that someone with a healthy immune system could be exposed to HIV many times without being chronically infected and that it is malnutrition that makes the immune systems of Africans weak and the diseases of TB, malaria and parasitic infections. "Water is key", clearly meaning clean water, without parasites and pollutants.
http://rethinkingaids.com/


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## rayo de sol (Sep 28, 2006)

Quote:


Originally Posted by *soso-lynn* 
Cases where a baby would be treated after a false positive would be if the mother was not tested during her pregnancy and only tested at the birth. At that time, there is no time to wait for confirmation since immediate treatment can literally save the baby's life.

What if the mother does NOT want her baby to receive drugs to "treat" a supposed HIV "infection"? Can she REFUSE treatment for her baby?


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## rayo de sol (Sep 28, 2006)

Quote:


Originally Posted by *soso-lynn* 
The actual rate of false positives for HIV tests (I mean with confirmation) is 1 in 250,000 and the vast majority of those cases have a known cause such as having partcipated in a vaccine trial or having multiple transfusions.

You can't NOT count screenings as part of the false positive statistics because they start drugging the baby based on the highly erroneous screenings! So, there are dire consequences of the false positives of the less-accurate tests.

Quote:

24 percent of the positive rapid "Single-Use Diagnostic System" (SUDS) HIV tests collected by the [New York] state health department turned out to be false on second check. Thirteen of the 17 newborns who received those inaccurate results needlessly started on toxic treatments of AZT and were not permitted to breastfeed while they waited days or weeks for HIV confirmation. One New York study showed a 67 percent false positive rate with the SUDS test.
How could anyone not be appalled by this?


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## rayo de sol (Sep 28, 2006)

Quote:


Originally Posted by *MegBoz* 
But even if a PG mom IS HIV+, she can refuse to treat the HIV. In which case, the maternity HCP would continue _maternity_ care just as normal. After all, can't people live healthy lives while being HIV+? So the HCP should treat the PG mama based on any symptoms she does show.
My point being, if an HIV+ Mama were to refuse treatment of HIV, it wouldn't impact how the pregnancy & birth are cared for anyway.

If she refuses treatment after testing HIV positive, the state might try to take her baby away from her once it's born.

If she tries to refuse treatment for the baby, the hospitals often call CPS, and they take the baby away and give it formula and AIDS drugs.

Read this article for more info: Safe and Sound Underground: HIV-Positive Women Birthing Outside the System


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## rayo de sol (Sep 28, 2006)

Quote:


Originally Posted by *Pirogi* 
How will a false positive change a mother's perception of her health, her body, her baby, her future? Should we be subjecting pregnant women to that kind of stress and disruption during her pregnancy? What is the emotional and psychological cost and to how many women and babies, and is that cost worth it to possibly find and treat a few HIV-positive babies? How many HIV-positive babies would actually benefit from this policy? What are the broader implications this holds for American women's ability to refuse standard care and treatment? For the US government's power over the physical bodies of its citizens?









Thank you so much for saying all this so eloquently, Pirogi. I completely agree.

Also, even if we assume that HIV is the cause of AIDS, why should we accept that the pharmaceuticals have the only method of healing from the disease?

What if a mother wants to use herbs (or other natural healing modalities) to heal her newborn of a supposed positive HIV test (assuming that the test was accurate)?

The law was made based on one flawed study from the pharmaceuticals, which (surprise!) said that their drug prevented the baby from staying HIV positive. Why would we ever trust a study that the pharmaceuticals performed themselves? They aren't objective. They have the most to gain.


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## rayo de sol (Sep 28, 2006)

Quote:


Originally Posted by *mamabadger* 
But how do you know that the further tests are accurate, and not giving a false positive? With other diseases, there might be obvious symptoms within a short period of time. Someone with a positive HIV test, on the other hand, might appear perfectly healthy in every way, and might continue to appear healthy for years.

There are many, many "HIV-positive" people living normal, healthy lives--as long as they stay away from the AIDS drugs. To read more about them, go to the Alive & Well website.

Quote:

There is no proof that HIV causes AIDS. In fact, all the epidemiological and microbiological evidence taken together conclusively demonstrates that HIV cannot cause AIDS or any other illness. The concept that AIDS is caused by a virus is not a fact, but a belief that was introduced at a 1984 press conference by Dr. Robert Gallo, a researcher employed by the National Institutes of Health (NIH).

Quote:


Originally Posted by *mamabadger* 
And if so, how do you distinguish AIDS symptoms from side effects of AIDS drugs, since I understand there is a great deal of overlap?

Excellent question! From what I've read, in an otherwise healthy person, non-drug user, non-inhabitant of a third world country (thereby having access to relatively clean water and nutritious food), AIDS drugs are THE CAUSE of AIDS. Big Pharma is killing people left and right.

Quote:


Originally Posted by *mamabadger* 
Maybe I am missing something obvious, but these are the concerns that would make me hesitate to accept an HIV test.

You are right to hesitate. Do your own research and fully inform yourself (and don't limit yourself to reading the mainstream propaganda), before you make this very important decision.

The book Inventing the AIDS Virus very thoroughly lays out why HIV is not the cause of AIDS. It is very scientific and well-cited. It's 722 pages long.


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## rayo de sol (Sep 28, 2006)

Quote:


Originally Posted by *Pirogi* 
What is NOT completely fine is your stubborn and elitist insistence that those who view the world differently are ignorant of the "facts." Science is changeable. This isn't a new problem. Remember when the earth was flat?









And I actually do believe very strongly that global warming is for real, but science is not cut and dried.

Science is changeable--and quite corruptible. Scientists don't want to lose their jobs, they want funding; to succeed in their field, they have to play along with the party line.

Many scientists are corrupt. They are the pawns of Big Business, especially Big Pharma. Where do you think their funding comes from?

Therefore, we can't take everything they assert at face value.


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## rayo de sol (Sep 28, 2006)

Speaking of science, we ended up following Louis Pasteur down the road of the Germ Theory of Disease, but Pasteur himself recanted his theories before his death. He stated that germs (bacteria and viruses) DO NOT cause disease. Rather, it is the overall state of our health that makes us either immune or susceptible to illness.

There are many theories of disease. We don't need to stay locked into our current hysteria about germs. Viruses can't hurt us if we're truly healthy. In fact, most bacteria and viruses are beneficial. Without them we would die.


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## rayo de sol (Sep 28, 2006)

Quote:


Originally Posted by *Pirogi* 
The sheer amount of funding available for AIDS research gives me pause

Me too! They can never admit that HIV doesn't cause AIDS because their HUGE house of cards would collapse, and sooooo many people would be out of a job. Not to mention all the lost profits to the pharmaceuticals selling all those worthless HIV tests and AIDS drugs. Yup, I predict that the AIDS powers that be will continue lying to people for as long as they possibly can.


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## rayo de sol (Sep 28, 2006)

Quote:


Originally Posted by *soso-lynn* 
Alos, it is important to understand that drugs are not necessarily started the second someone gets a confirmed positive.

Untrue.

Quote:

When treating pregnant women who test positive for HIV, most physicians follow US Public Health Service guidelines, which include aggressive combinations of anti-HIV drugs during pregnancy and AZT administered intravenously during labor, followed by formula feeding and six weeks of AZT for newborns, whether or not they test positive.2 But many doctors, like Dana's, add their own codicil--a call to Child Protective Services if the parent doesn't comply.
http://www.mothering.com/safe-and-so...outside-system


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## wombatclay (Sep 4, 2005)

~~~A note from your friendly neighborhood moderator~~~

MDC is an amazing, vibrant, and passionate community. In such a community there are bound to be disagreements. Please help us keep MDC welcoming as well as informative by following the user guidelines!

Quote:

*Do not post in a disrespectful, defamatory, adversarial, baiting, harassing, offensive, insultingly sarcastic or otherwise improper manner, toward a member or other individual, including casting of suspicion upon a person, invasion of privacy, humiliation, demeaning criticism, name-calling, personal attack or in any way which violates the law.*

Quote:

Do not post or start a thread to discuss member behavior or statements of members made in other threads or to criticize another discussion on the boards. *Do not post to a thread to take direct issue with a member. If you feel a member has posted or behaved inappropriately in a discussion, communicate directly with the member, moderator or administrator privately and refrain from potentially defaming discussion in a thread*.
Although this thread has returned to Birth & Beyond, please note a general discussion of HIV/AIDS belongs in the Health & Healing forum. Please help us maintain the "birth" focus in this thread and consider starting a seperate thread in Health & Healing to discuss HIV/AIDS more generally.


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## soso-lynn (Dec 11, 2007)

Quote:


Originally Posted by *rayo de sol* 

What if a mother wants to use herbs (or other natural healing modalities) to heal her newborn of a supposed positive HIV test (assuming that the test was accurate)?

The law was made based on one flawed study from the pharmaceuticals, which (surprise!) said that their drug prevented the baby from staying HIV positive. Why would we ever trust a study that the pharmaceuticals performed themselves? They aren't objective. They have the most to gain.

There is a lot more than one study that shows how efficient treatment is in preventing transmission to the baby. I am all for natural minded health care but herbs cannot prevent a retrovirus from replicating just like herbs will never make a woman whose tubes are blocked get pregnant. There are some things that require drugs, even sometimes risky drugs with high toxicity. Once again, all this fear of treating babies over false positives can be avoided by simply not waiting until labor (hence when there is no time to get an accurate result) to get tested. Those quick tests you mentionned are actually not recommended and probably have not been used in a long time.

Also, HIV is actually one area of research that gets lots of non-pharmaceutical research funds. There are many activism and community groups who look very closely at what research is being done and they tend to get very loud about it so the big pharma conspiracy really does not hold up for HIV. Perhaps a little look at the history of HIV research would help you understand the dynamics behind it.

Quote:


Originally Posted by *rayo de sol* 
Me too! They can never admit that HIV doesn't cause AIDS because their HUGE house of cards would collapse, and sooooo many people would be out of a job. Not to mention all the lost profits to the pharmaceuticals selling all those worthless HIV tests and AIDS drugs. Yup, I predict that the AIDS powers that be will continue lying to people for as long as they possibly can.

I wish I could just ignore this kind of statement but it is just way too dangerous to say nothing when people make such comments. Perhaps if you get the opportunity, you should go in a lab and look at an actual HIV virus in action. This is not made up. Perhaps you could go volunteer at a local AIDS clinic and see for yourself the reality of it. I would love to see you explain to my neighbour that the fact that he is dying right now has nothing to do with the positive HIV tests he has been getting since the early 90s.

This distinction between AIDS and HIV is an old concept of the beginning of the pandemic when it was not fully understood. AIDS was defined by the secondary infections and diseases acquired from HIV infection. Now that we do understand the mechanism behind HIV and its evolution, that classification is no longer necessary. I would like for you to explain what AIDS is if you do not think it is related to HIV, given that the diagnostic criteria for AIDS involves having HIV.

Finally, when I say that there is no debate in the scientific community, I do not include people with dubious credentials and clear agendas. Debate among people who do not understand (or chose to ignore) the science is not debate among scientists but debate with scientists.

To get back to the issue of prenatal testing for HIV, I do think that people with different views (no matter how unfounded) should have the right not to get tested. However, I also think that when someone's views on a disease put them at greater risk of transmitting it (I assume that people who do not believe in STDs do not use proper protection and perhaps would not notify their partner if they had a positive test show up), it is very difficult to stand by and do nothing, especially when it comes to an infant for whom transmission can be prevented.

People who are concerned with HCPs taking quick actions without full evidence of infection or CPS getting involved in medical treatments (or informed refusals of medical treatment) should not be arguing the old myths and misconceptions about HIV but rather fighting to bring true and evidence-based information to those involved. The only reason anyone would forcibly prevent an hiv-positive mother from nursing her baby or force treatment for no good reason is if they are stick in the middle of the hysteria and panic surrounding HIV. Get rid of that hysteria and the alleged threat of lives being destroyed over HIV testing stops existing.


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## pumpkinhead (Sep 15, 2003)

Quote:


Originally Posted by *rayo de sol* 







And I actually do believe very strongly that global warming is for real, but science is not cut and dried.

Science is changeable--and quite corruptible. Scientists don't want to lose their jobs, they want funding; to succeed in their field, they have to play along with the party line.

Many scientists are corrupt. They are the pawns of Big Business, especially Big Pharma. Where do you think their funding comes from?

Therefore, we can't take everything they assert at face value.


Wow, as a scientist, that perspective it pretty defeating. Judging the group by the fringe is rarely a good idea.

I assure you the majority of scientists aren't pawns of Big Pharma and not all funding comes from them. In fact, unless you are a commercial scientist and you work directly for them, very little funding comes directly from Big Pharma. Most of the money comes from granting agencies.


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## MegBoz (Jul 8, 2008)

Quote:


Originally Posted by *soso-lynn* 
I think that the easiest way to overcome that and stop the social devastation caused by HIV is to *start viewing it as any other infectious disease and not as something special or different.* It is really ridiculous that we are at the point where some legislations feel the need to make it mandatory. Most of those laws actually come from the point of view that *making it compulsory alleviates the burden on patients of having to fully disclose their lifestyle or be afraid that asumptions will be made about them if they choose to get it done.* For example, there is no need to make testing for rh sensitization required by law since no stigma is attached to a positive result.

Bolding mine

HOW can we view it as "any other infectious disease"? It IS transmitted through sex (or needles). Why would we ignore that fact? What would we have to gain by ignoring that fact in order to view it as "any other infectious disease"?

If you are correct that the laws were created, at least in part, to "alleviate the burden" of choosing to get the test, I think that is awful, just absolutely terrible. Having government "play Mom" & tell me they know what is best for me, and they will decide for me is atrocious.

Also, as I've posted before, it could simply be alleviated by my MW saying to me, "Yeah, Meg, you're right, I'm sure you don't have it! I'd just like to test anyway, it makes me feel better to get it on the books & we're taking blood anyway." I would literally







and say, "OK."

Quote:


Originally Posted by *soso-lynn* 
*When people start equating getting tested for certain diseases with the level of trust in their marriage and other things of the sort, we end up with simple things reaching irrational levels of complication* such as laws forcing things on patients.

Again, bolding mine.

Ok, this really confuses me.







I was one who said previously that I don't need to re-test for HIV because I trust my DH - and to tell me I should get tested anyway is to tell me I should NOT trust my DH.

I'm not "equating the disease with the level of trust in my marriage." *It is simply fact!* DH & I don't do IV drugs & have never had a blood transfusion. So sex is the only way we could get HIV, right?

OK, so if I was already HIV negative after being married to him for 5 years when I had DS, (So we will assume DH is also HIV-), and we continue to have sex with _only_ one another, then *what is the point of getting HIV tested again whenever I have baby #2???* There is no way I could have contracted HIV now unless my DH has cheated on me! Or am I missing something here?
I am not making some sort of artificial connection with HIV testing to the trust level in my marriage - that is simply the fact of the matter.


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## MegBoz (Jul 8, 2008)

Quote:


Originally Posted by *noobmom* 
Agreeing that a HIV test can be mandated does not mean I think that a pregnant woman needs to agree to everything. It's one test.

So where do you draw the line??? *My point is that it is wrong to ever force a woman into any medical procedure or treatment.* Wrong. Period. I don't care that it is "just one test!" The fact that it is "just one test" doesn't change that. As Pirogi states, it's a bodily integrity issue.


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## Spirit Dancer (Dec 11, 2006)

Quote:


Originally Posted by *MegBoz* 
Bolding mine

HOW can we view it as "any other infectious disease"? It IS transmitted through sex (or needles). Why would we ignore that fact? What would we have to gain by ignoring that fact in order to view it as "any other infectious disease"?

If you are correct that the laws were created, at least in part, to "alleviate the burden" of choosing to get the test, I think that is awful, just absolutely terrible. Having government "play Mom" & tell me they know what is best for me, and they will decide for me is atrocious.

Also, as I've posted before, it could simply be alleviated by my MW saying to me, "Yeah, Meg, you're right, I'm sure you don't have it! I'd just like to test anyway, it makes me feel better to get it on the books & we're taking blood anyway." I would literally







and say, "OK."

Again, bolding mine.

Ok, this really confuses me.







I was one who said previously that I don't need to re-test for HIV because I trust my DH - and to tell me I should get tested anyway is to tell me I should NOT trust my DH.

I'm not "equating the disease with the level of trust in my marriage." *It is simply fact!* DH & I don't do IV drugs & have never had a blood transfusion. So sex is the only way we could get HIV, right?

OK, so if I was already HIV negative after being married to him for 5 years when I had DS, (So we will assume DH is also HIV-), and we continue to have sex with _only_ one another, then *what is the point of getting HIV tested again whenever I have baby #2???* There is no way I could have contracted HIV now unless my DH has cheated on me! Or am I missing something here?
I am not making some sort of artificial connection with HIV testing to the trust level in my marriage - that is simply the fact of the matter.

I agree with what MegBoz is saying. My dh and I were virgins when we got married and have only had sex with each other (no drugs or transfusions either). WIth my 1st pregnancy I declined HIV testing (thankfully here in Canada it is optional) because I am 100% sure I do not have it. I do 100% trust my dh. And no I am not stupid or naive. It seems or society has a problem with trust anyway. I hear a lot, "Oh I trust ___ but just to be sure..."
I also declined STD testing and I was offended when my dr said "But you can never be sure...", implying my dh may have cheated. How in the world is it her place to judge my marriage AND try to undermine MY OWN health care decisions?

I do not think the government has ANY right to mandate any medical or health choices for me or my family (including PKU or whatever) . I am appalled and even scared at the ever increasing role of authority the government is taking in this area. Honestly what is next? For example I am sure down the road there will be some type of forced vax? And if you force the HIV test on a mama, then say she is positive they will force drugs on her baby and formula. So in the US at this point it is forced testing AND treatment (CPS taking a newborn from its mama is force). Really what next? Honestly all this is part of why I have chosen to UP/UC my currant pregnancy.


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## MiaMama (Jul 21, 2007)

But sex and needles are not really the only way to get some of the viruses, they are just the most common ways. Right? They are "blood-borne pathogens." At some previous jobs I have worked, we had extensive training in universal precautions, because we do not have to have sex with people in order to be exposed to bodily fluids.

Now, I am not sure how long the HIV virus can survive outside the body, so I am not sure if someone could be exposed to enough bodily fluds to transmit the virus without knowing it. However, I know I have had my BIL's blood on me when he gashed his foot open and I rushed to help him. I don't know enough about his health status to rule that out as a potential source. But, I did not share needles with him OR have sex with him.

I wonder who my husband has helped when injured or sick in the past 5 years? Part of the reason I trust my husband completely is because I know he is the type of person who would never hesitate to assist someone in trouble.

Also, how many times in history have doctors themselves accidentially spread disease? I have had blood draws, and I am pretty sure the office used proper contamination procedures, but am I 100% sure? Not quite.

I am not saying I support mandatoy anything, I am just saying that there are other possible infection vectors other than sex or drugs.


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## soso-lynn (Dec 11, 2007)

Quote:


Originally Posted by *MegBoz* 
HOW can we view it as "any other infectious disease"? It IS transmitted through sex (or needles). Why would we ignore that fact? What would we have to gain by ignoring that fact in order to view it as "any other infectious disease"?

If you are correct that the laws were created, at least in part, to "alleviate the burden" of choosing to get the test, I think that is awful, just absolutely terrible. Having government "play Mom" & tell me they know what is best for me, and they will decide for me is atrocious.


As MiaMama said, sex and IV drugs are not the only way to transmit HIV. There are many other diseases that can be transmitted through sex that do not have the same social context as HIV. People do not panic over an hepatitis or HTLV test the same way they do over HIV, for example.

As far as what I said about the laws, I was simply making the point that, while mandatory testing might not be the solution, the ideology behind those laws was not to control and enslave people's bodies but rather to solve a real problem of people being scared to get tested because of social repercussions of doing so. I think that when discussing a law and its social consequences, it is important to look at the initial goal of such legislation. In this case, there is a lot more to it than government trying to invade people's privacy.


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## MegBoz (Jul 8, 2008)

Quote:


Originally Posted by *soso-lynn* 
the ideology behind those laws was not to control and enslave people's bodies but rather to solve a real problem of people being scared to get tested because of social repercussions of doing so.

OK, then _education_ is the key here - educating people on the fact that you can get HIV other ways besides sex, blood transfusions & needle-drug use. There you go. That's the solution! Education & allowing people to make their own healthcare decisions.

Incidentally, I've also had "blood-borne pathogen" training. If I was exposed to the blood of a stranger, I'd get the HIV test. & I do think it's wise for a healthcare professional, such as nurse of EMT to get tested, as well as perhaps to get the Heb B vax. But DH & I work behind computers all day. Neither of us has _ever_ encountered any strange blood! It's not part of our lives.


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## rayo de sol (Sep 28, 2006)

This movie looks really interesting.

House of Numbers


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## soso-lynn (Dec 11, 2007)

Quote:


Originally Posted by *rayo de sol* 
This movie looks really interesting.

House of Numbers

Ok, so science is biased and cannot be trusted yet a documentary with a bunch of out-of-context quotes and interviews with lunatics that ends up doing nothing more than showing that those lunatics exist should be proof that HIV is not real? I have seen this and can assure you that in no way does it advances your argument.


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## Sorin (Nov 7, 2005)

I almost hesitate to dip my toe into this discussion, but it was on my mind because I just had a conversation with my midwife yesterday on this exact issue. I have been tested for HIV, HepB, and will be tested for HepC at my next visit. I have absolutely no problem with it, and I understand the reasons behind it. I want to have a waterbirth, and my status is necessary for my care providers to know to even make a waterbirth possible at the hospital where I am delivering. As we know, birth is a messy business, perhaps a bit more so in a tub (at least in terms of bodily fluids floating around instead of being wiped/whisked away!) Knowing that I am negative makes a waterbirth for me possible, as they will not allow (whoops! There's that dreaded word!) a woman who is positive for any of the above diseases to have a waterbirth. This is a policy in place for the protection of the care providers, and I understand it. Why should they take my word for it that I am negative when it comes to the protection of their own health? Poke me, draw some blood, test it, prove that I'm negative, and let's get rolling on this waterbirth.

I also understand the need for state mandated testing. We live in a society, and we (the people, the government, ect.--fit whatever "we" you want to in here) have an obligation to take care of the citizens in that society. You know that saying, "Your right to swing your fist ends when it hits my nose?" To me, state mandated HIV testing is the same thing. I absolutely have the right to refuse to be tested in 99.9% of all situations. BUT, when I became pregnant, it is just not about me anymore. There is a baby to think about. There are care providers to think about. I can argue to high heaven about my 0% risk, but the fact is that people lie. People are unaware of what really constitutes risk. People are deceived. If I have to "succumb" to mandated testing so that a doc or midwife can catch an unsuspecting woman who turns out to be HIV+ despite the fact that she truly believed that her partner was faithful and then move to help her give birth to a healthy baby and get treatment for herself so that she can go on to live a long and fulfilling life, then go ahead and stick me. I'm part of this society and care about all members in it. I have to get a license to drive a car. I have to register to vote. I have to obtain a degree to do my particular job, and I have to get an HIV test to give birth within the US medical system. I do not have a problem with any of these scenarios.


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## MiaMama (Jul 21, 2007)

Quote:


Originally Posted by *MegBoz* 
OK, then _education_ is the key here - educating people on the fact that you can get HIV other ways besides sex, blood transfusions & needle-drug use. There you go. That's the solution! Education & allowing people to make their own healthcare decisions.

Incidentally, I've also had "blood-borne pathogen" training. If I was exposed to the blood of a stranger, I'd get the HIV test. & I do think it's wise for a healthcare professional, such as nurse of EMT to get tested, as well as perhaps to get the Heb B vax. But DH & I work behind computers all day. Neither of us has _ever_ encountered any strange blood! It's not part of our lives.

I totally agree that education is key.
For example, the CDC has documented cases of people aquiring HIV from their dentist and acupuncturist. It is *very very* rare, but I would be hard pressed to say I am 100% sure that there is no way I have been exposed. Maybe 99.999%?

I also agree that people should be able to make thier own healthcare decisions.


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## nudnik (Aug 9, 2006)

What I think is the main issue here is not the testing, it's the treatment. If you are tested positive (or "maybe" positive), you can be forced into treatment you don't want. If you refuse to be tested, your baby can be forced into treatment you don't want.

Personally, I have no problem getting another test if they're drawing blood anyhow. Same with the PKU. It's information that could only help, right? It's the way they react to the test that worries me. If PKUs led to lots of babies being taken away from their mothers or drugs being forced on them, I might rethink that too.


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## soso-lynn (Dec 11, 2007)

Quote:


Originally Posted by *nudnik* 
What I think is the main issue here is not the testing, it's the treatment. If you are tested positive (or "maybe" positive), you can be forced into treatment you don't want. If you refuse to be tested, your baby can be forced into treatment you don't want.

Personally, I have no problem getting another test if they're drawing blood anyhow. Same with the PKU. It's information that could only help, right? It's the way they react to the test that worries me. If PKUs led to lots of babies being taken away from their mothers or drugs being forced on them, I might rethink that too.

If you were HIV positive, would you really refuse treatment to prevent transmission? I think the number of people who actually refuse treatment after reviewing the available data and actually being diagnosed with HIV is way too low to even be significant. Within the community of people with HIV, it is widely agreed that the medical care that can prevent transmission to the baby has completely changed the lives of many HIV-positive women who now have the choice to become mothers despite their condition.

There are so many other situations where treatment would potentially be "forced" if parents refused it. Overall, if there is a significant risk to the baby that can easily be avoided, very few people would think it is acceptable to not do anything. I am pretty sure that if the PKU test showed an abnormality that was later confirmed, refusing treatment would not go over too well with doctors and potentially with judges. Or, if your baby needs oxygen at birth, your refusal would likely be ignored as well. If you're positive for gonorrhea while pregnant, refusing treatment would probably not be an option. If your child is choking on something at school, the certainly would disregard any orders you would give to let the child die. To me, those things do not even lead to a debate over freedom and such as it is so obvious that treatment is important and people just don't refuse unless they are severely miseducated on the facts.


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## MegBoz (Jul 8, 2008)

Quote:


Originally Posted by *Sorin* 
I also understand the need for state mandated testing. We live in a society, and we (the people, the government, ect.--fit whatever "we" you want to in here) *have an obligation to take care of the citizens in that society.* You know that saying, "Your right to swing your fist ends when it hits my nose?" To me, state mandated HIV testing is the same thing. I absolutely have the right to refuse to be tested in 99.9% of all situations. BUT, when I became pregnant, it is just not about me anymore. There is a baby to think about.
<snip>
I'm part of this society and care about all members in it. I have to get a license to drive a car. I have to register to vote. I have to obtain a degree to do my particular job, and I have to get an HIV test to give birth within the US medical system. I do not have a problem with any of these scenarios.

Bolding mine.
These sentiments make me








If your HCP says, "I won't attend your waterbirth unless you are tested," well, that is the HCPs right & I fully support it! If that is how they feel, & how they choose to practice, that is their right.

But your points about a baby... uh... *you make it sound as if protecting my baby is the responsibility of the government!* & that's what makes me







. No, it's up to me - the mama! Yeah, if I'm proven to be criminally endangering my child, then the state should save him (i.e. take him from me), but health care decisions, _within reason_, are mine to make. & not testing for everything under the sun is, to me, within reason* - therefore I don't want the government butting in & mandating that I test.
*Note I do think it's good to be tested, but I also think it is "within reason" to refuse.

Again, the sentiment that _"The government/society has an obligation to care for the citizens"_ as justification for legally mandated testing can SO EASILY be extended to legally mandating ALL KINDS of healthcare! Remember, there have been rare cases were the law was used to FORCE women into unwanted repeat c-sections! (The OBs genuinely thought VBAC was way too dangerous of a risk to put a baby through!) And as we all know, many, many HCPs think it's a "needless risk" to forgo or even delay vaccines.

Why do you all think it's OK to legally mandate this one particular piece of healthcare practice & not others? Why also do you not think that this opens the door to more & more legal requirements of healthcare practices?

As for the statement that, "I don't mind, go ahead & stick me."







I've posted it before & I'll post it again - whenever I get PG with #2, I plan to have an HB & if my MW says, "Yeah, I know, it's a 1 in a million shot that you have HIV, but I really just prefer you test for it." I'll say







"OK, no problem!" It's not the testing itself I'm fighting against on this thread, it's using THE LAW to force ANY healthcare decision that I'm opposed to.

(OK, imminent death exempted here, such as choking, that's a "life & death issue" rather than a 'health care practice' issue.)


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