Imagine Las Vegas disappearing overnight and leaving nothing behind but empty stages and barren casinos, becoming nothing short of a ghost town. If all the people that have died from HIV/AIDS in the United States since the beginning of the epidemic were taken out of one geographical region, Las Vegas could easily be erased.
The three most common ways to contract HIV are: unprotected sex with an infected partner, injecting drugs using an unsterilized needle that has been used by someone who is infected or during pregnancy, labor or delivery or breastfeeding where the mother transmitted the virus to her child. If an infected woman, not seeking treatment, becomes pregnant, the chance of her transmitting the infection to her child ranges from 15-45%. An infant, who has not even had the chance to speak, walk, or enjoy life, has such a high risk of contracting a deadly infection because the mother did not consult with her doctor and seek the appropriate treatment during her pregnancy.
Did she not seek treatment because she did not know that she was infected, did she know but was too ashamed to relay the information, was she afraid she could not afford treatment? If routine HIV tests were conducted along with all the other blood tests throughout a pregnancy, infections would be indentified, treated with precaution and it would allow doctors to dramatically reduce the risk of mother-to-child HIV transmission. With effective interference, the chances would be reduced to below 5%. With this knowledge, HIV screening must be made mandatory for those seeking any form of prenatal care.
The Center for Disease Control and Prevention (CDC) estimates that 1,148,200 people (13 years and older) in the United States are living with HIV; 18% of those people are unaware they are infected. The infection rate has stabilized over the last few years to roughly 50,000 new infections each year—that means that someone in the US is infected with HIV every 9 minutes. HIV and AIDS are not the same. HIV stands for Human Immunodeficiency Virus.
This strand cannot stand as a virus alone and reproduce; it needs to infect the cells of a living organism. Normally, the immune system fights off unwanted viruses but this particular virus attacks the immune system directly, preventing it from destroying the unwanted virus and repairing damaged cells. AIDS is a condition that is caused by the irreparable immune system. When the immune system is damaged this badly, it is incapable of fighting off any infection. If left untreated, it takes, on average, ten years for someone to develop AIDS from the date of infection.
This average takes in to account a healthy diet and lifestyle—not someone who may be suffering from malnourishment or other unrelated illnesses. Women are more susceptible to being infected with HIV through heterosexual sex and infected needles than men.
The number of HIV positive women in the US, of child-bearing years, is still growing at a rapid rate. They account for roughly 23-25% (11,000-12,500) of new infections each year. In a recent study conducted by the CDC, only one in five women between the ages of 18 and 64 report that they have been tested for HIV in the last twelve months. Among those women who are HIV positive, 31% of them were diagnosed in the later stages of HIV, resulting in an AIDS diagnosis within one year.
Women who are HIV positive have the possibility of transmitting the virus to their child during labor or post labor, during breast feeding. There are approximately 2000 babies being born with HIV each year and more become infected as a result of breastfeeding. This is by far the smallest group of people infected per year, but this number could be reduced to almost zero, if proper interventions were mandatory.
When women think or realize that they are pregnant, they seek out a gynecologist or other medical professional to aid them throughout their pregnancy. They are put through numerous blood tests to ensure they have the appropriate vitamin and glucose levels.
They even undergo a STD test that tests for a variety of sexual transmitted diseases, excluding HIV. Some professionals offer the test and try to convince their patient that it is important, but some still refuse. Implementing mandatory HIV tests for pregnant women ensure that more people get tested, educate on the effects of HIV, are able to get treatment, and dramatically reduce the chance of their child contracting the virus.
The test should be performed with the routine STD test at the beginning of the pregnancy and then once again before labor, because it can take up to six months for the virus to show up during a screening. The woman would know whether she has contracted HIV and have the ability to discuss the options with the doctor. Treatment should accompany the pregnancy, if needed, at no cost.
The treatment for the baby after delivery would also incur no cost. A major, non-political, concern about mandatory testing is the cost associated with treatment. It does not seem logical, but HIV treatments are extremely expensive. It costs thousands of dollars each year for medications and regular doctor’s visits. For people who have full coverage insurance, the cost for the medication is almost completely covered but they still have to pay the co-pays to visit the doctor. There are also federally funded programs to assist with HIV costs, and though they might regulate which medications patients can take, most doctors would prefer that a patient be taking some sort of medication rather than none at all. And finally, there are other programs such as Medicare and Medicaid that assist those who are HIV positive.
Although some states will not grant acceptance in the Medicaid program unless the diagnosis is AIDS, many states will cover the costs with a positive HIV status. All of these options must be presented after the baby is born and doctors should work with their patients to find the best option. Another concern, brought up on the political floor, is that mandatory testing violates the Constitution. If a mother knows the status of her or her child, involuntarily, that violates her right of privacy and subjects her to discrimination; she could lose her job, insurance, face discrimination in society or physical abuse at home (McMillion).
Making sure that no infant is involuntarily infected with HIV should be the first priority, of not only health care providers but by mothers themselves. The American Medical Association (AMA) was originally against mandatory testing because there was little a doctor could do to help treat the pregnant mother and unborn child. With new discovery of AZT, the treatment used to reduce the rate of transmission, the AMA has reversed their opinion (Schuyler).
The mandatory testing will not allow women to forever remain ignorant about their status. It forces women to face the disease much earlier in their lives and presents them with a choice, a choice that replaces the one that was taken away—let the HIV take its course but help reduce her baby’s chance, seek treatment for her and the baby or do neither of them and take the risk of exposing her child.
Courtney from Study Moose
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