South Carolina, and New York that could change existing statutes on the issue of prenatal or newborn testing and counseling. In Indiana, legislation passed in late February that explicitly allows physicians to order confidential HIV testing of newborns if the mother has not been tested and refuses the test and if the physician believes that the test is medically necessary for the newborn. The state health department has been instructed to issue implementation guidance. One consequence of the legislative debate on this topic is a new awareness in Indiana that physicians are not providing HIV counseling to all pregnant women and are not offering tests. As a result, the health department is now pursuing an emergency rule that would try to ensure or compel physicians to counsel pregnant women. Mr. Kelly said it is likely that other states will try to implement similar newborn screening legislation.

Discussion

During discussion, it was noted that Louisiana may have a similar stipulation that allows physicians to test infants or children if they believe it is medically necessary. One participant noted that in New York, before newborn screening became mandatory, physicians testified that they did not need this kind of law because they had the legal right to test in any case.

Rebecca Denison, Respondent

Ms. Denison spoke from her perspective as an HIV-positive woman. She chose to become pregnant and is now the mother of two-year-old twins who are HIV-negative. Ms. Denison directs Women Organized to Respond to Life-threatening Diseases (WORLD), an organization started by and for HIV-positive women. In this capacity, she has worked closely with and assisted many HIV-positive women.

Ms. Denison started by noting that it is remarkable and heartening to hear meeting participants take seriously the notion of providing medical care to HIV-positive women who want to become pregnant or continue pregnancy. She observed that this is a moving tribute to those who have been willing to look beyond the conventional wisdom and understand what is in the hearts of people who want to become parents. She also reminded participants that beyond all the statistics, there are a lot of emotional issues tied into HIV/AIDS that will never be captured in numbers, but that profoundly affect people's lives.

Ms. Denison followed with a series of observations on a number of issues:

  • Expanding therapy options: Ms. Denison noted that it is important to recognize that in practices such as BAPAC in San Francisco, treatment options go well beyond the ACTG 076 protocols. For example, in the past two years, BAPAC has provided clinical care that incorporates the clinical evaluation of


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