have been even more eager to get high as an escape from the possibility that she might be infected with HIV. In her judgment, testing of pregnant women should be voluntary for all women except those using drugs. "If you're on drugs," she said, "I think they should just test without asking.… When I was on drugs, I didn't want to find out."

Patient 2: Rita

Rita, an African-American mother of two girls, was diagnosed with HIV around the time she learned of her second pregnancy. Her health clinic asked her to take an HIV test immediately after they diagnosed the pregnancy. Rita agreed to the HIV test thinking that the results would be negative. "I was so surprised by the results that I spent one to two months in denial.… Once I adjusted, I was able to cope, take my medicine." With the support of her counselor at Bellevue, she started antiretroviral therapy at five months of pregnancy and encountered no side effects. Her decision to proceed with therapy was based on her concern for her child. Her newborn daughter is HIV-negative, as is her older, nine-year-old daughter.

She felt compelled to conceal her HIV status from her family, with whom she lives, for fear of "being thrown out of the house." To disguise the true purpose of the medication for her newborn daughter, she told her family that it was for sickle cell disease. She did, however, notify the father and unsuccessfully urged him to get tested. Said Rita, "I told him to get the test, but he won't."

Patient 3: Janet

Janet is an African-American women who was told she was HIV-positive early in her first pregnancy. She was stunned by the news because she did not know she even had been tested. "I would have preferred them to ask me," she reflected, "because I would've said yes." Despite the receipt of antiretroviral therapy before, during, and after delivery, her one-year old child is HIV-positive. Janet became pregnant again soon after the birth of her first child. Her second child also received an aggressive regimen of antiretroviral therapy. The HIV status of the second child, who was only three weeks old at the time Janet spoke to the committee, is not yet known. The father of her children died of AIDS, as did her sister. When advising her friends to get tested for HIV, she said, "They get offended. They say, 'You're crazy, girl.'"

Patient 4: Elina

Elina is a 26-year-old Hispanic mother of two daughters. Her first child, born five years ago, is autistic. She found out that she and her second daughter were



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