Friday, December 28, 2007

Unfair or Practical?

If you go to your doctor and ask for an IUD, she or he will require you to undergo a test for chlamydia and gonorrhea, along with a pregnancy test.  This is to ensure that 1) you're not already pregnant and 2) that you don't have a pre-existing condition that would be worsened by the insertion of an IUD.

I'm in a hugely low risk group for any STD, and yet, I understand that some medical procedures require me to undergo testing for various STDs to ensure that the procedure won't harm me.  I'm not at risk for HPV, but I got the HPV vaccine anyway, since it can't hurt to be protected.
In New Jersey, a new law just passed making an HIV test mandatory for pregnant women.  As a result, some people are calling this an invasion of privacy and decrying the law as unfair.  And the first thing that occurred to me was the various STD tests I've had to go through, even though I'm not at risk.  

The point of the New Jersey law is to be able to provide pregnant HIV positive women with antiretroviral medicine to help prevent transmission of HIV to the fetus.  If a HIV positive mother is provided with antiretrovirals, the chance of the fetus receiving HIV from its mother is 2%.  According to the article (linked above), the test is recommended anyway and 98% of mothers are already given the test anyway.

The point of the law is to help identify the virus in women, a rising risk group, particularly among Black women, and to prevent the spread of HIV in the womb.  I see this as a very practical law, because once people with HIV and AIDS are identified, they can be provided with medical treatment.  

The mandatory screening has raised privacy concerns. The American Civil Liberties Union of New Jersey and the state's chapter of the National Organization for Women both questioned whether the mandated tests violate a woman's right to privacy and the right to make her own medical decisions.

Riki E. Jacobs, executive director of the Hyacinth AIDS Foundation, a New Jersey nonprofit helping people living with AIDS, said the law is unnecessary and comes when the state should be focused on expanding care for pregnant women. "I am adamantly opposed to this bill. New Jersey already reduced the perinatal rate of transmission with mandatory counseling of pregnant women," she said. "The issue is getting those women who are not in prenatal care in for services and testing. I definitely think it is an invasion of privacy," Jacobs said. She said women choose to test their babies in 98 percent of cases, so the new law's mandatory provisions for testing children are not needed: "The fact that we assume women won't choose to test is ludicrous and wrong."

I really don't agree with Ms. Jacobs.  I feel that if the state were trying to enforce mandatory treatment of a disease on people, that would be one thing, but this is simply a test to catch a very deadly disease.  And it's not an invasion of privacy in my opinion--HIV status in a pregnant women in important to know should complications arise.  I feel that everyone should be tested for HIV, since it can lurk in the system for a long time before showing symptoms, and be passed on without the infected being aware of it. 

I think the real reason people see this as an invasion of privacy because there is still a terrible stigma attached to HIV and AIDS.  When someone has cancer, you offer sympathy; when some has AIDS, you wonder how he or she got it.  It's a disease that is associated with everything America prudishly disdains: gays, sex, and drugs.  The problem with this tunnel vision view is that it's no longer a disease that hangs out dark back alleys among needle drug users, it's a disease that is everywhere, lurking undetected.

I don't see it as an invasion of privacy to have a test.  The results are between you and your doctor.  I don't see it as an invasion of privacy if the end result is less children born with HIV.   If the law were to require that all HIV positive women would have their children taken away from them, I wouldn't agree with that.  AIDS and HIV are an epidemic, and I think we need to focus of stopping them through prevention.

1 responses:

Vanessa said...

I realise that legally the unborn have no rights. (I'm pro-choice.) However, assuming that the mothers that are going to receive the test are receiving it because they plan to carry their pregnancies to term, isn't it a little inconsiderate to not have the test and treatment if they have HIV?

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