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HIV testing GRR - Page 2

post #21 of 65
Thread Starter 
we cant afford a midwife
post #22 of 65
Thread Starter 
whew just called all neg i hate waiting
post #23 of 65
I don't know where in TX you are, but there are midwives who accept insurance and even medicaid.

-Angela
post #24 of 65
Quote:
Originally Posted by Ceili View Post
Seriously? My midwife could care less if I had the test done. And the OB who orders my bloodwork basically asks me what tests I want. When we got to HIV I declined, she asked why, I mentioned that I'd been in a committed monogamous relationship for the past 15 years, I'd tested negative in college several times, and that there was a higher rate of false positives in pregnancy. She said okay and that was that.
For some reason most doctors never believe any of that, if it comes from me, maybe I am to young (30years old)? They insist, they can only treat me, if I have those tests done. And threaten, that they would assume, that I am HIV+, which would require a CSection.

I am not anymore with this office, but those doctors exists.
post #25 of 65
Quote:
Originally Posted by StephM76 View Post
In my state if you refuse they will take your baby (if you birth in a hospital) and draw blood to test them for it. I am not sure what they do if you homebirth and refuse the test.
Ditto. I'm in NY. They absolutely will NOT let you hold your baby until they test him/her 1st. It's state law. We also cannot refuse Vit. K or eye goop without them calling Child Services. Its BS but I'd rather not deal with CPS and all it's ramifications for them to do a simple test when they're drawing blood anyway, yk?

I had a home birth (attempted) with #1 and I did the test b/c it was my 1st pregnancy. I'm pretty sure if your midwife allows you to skip other testing she won't do anything about the HIV.
post #26 of 65
It is routine here to offer the test, but you can refuse certainly and it is no big deal. I had to sign a form saying I either accepted or declined it, just like every other test they wanted to run. I got tested all the time when I give blood (but I haven't for about a year in preparation for TTC and obviously not now since I am pregnant) so I knew I wasn't positive, but they really wanted to run the test, so I went ahead and consented since I don't care and knew it would be negative. I did decline the AFP and no one batted an eye at that.

And there is no reason for them not to let you know the results. If they aren't, just call and ask. I would consider finding a new doctor who understands that patients have a right to informed consent/refusal.
post #27 of 65
Quote:
Originally Posted by murphysaangel View Post
Ditto. I'm in NY. They absolutely will NOT let you hold your baby until they test him/her 1st. It's state law. We also cannot refuse Vit. K or eye goop without them calling Child Services. Its BS but I'd rather not deal with CPS and all it's ramifications for them to do a simple test when they're drawing blood anyway, yk?

I had a home birth (attempted) with #1 and I did the test b/c it was my 1st pregnancy. I'm pretty sure if your midwife allows you to skip other testing she won't do anything about the HIV.
Newborn testing is a separate issue. 10 states (including NY) mandate testing of the newborn. In these states, newborn testing is completely mandatory, meaning a government agency requires citizens to undergo testing, with sanctions imposed on those who do not comply.
post #28 of 65
Quote:
Originally Posted by JD5351 View Post
If they don't call you, I'd think it pretty fair that it came back negative. But if you call them, they'll let you know your results.
That's how it was in my case. I called the office to find out about something else and while I was on the phone the nurse went ahead and offered my info on the blood tests for the STDs that I had gotten a week earlier. They were negative so that's probably why I didn't get a call or a notice about it.
post #29 of 65
Quote:
states/territories are opt out, 30 states/territories have voluntary programs, or opt in. In opt in situations, the test is not routinely offered; the patient must request it.

So, you do not HAVE to have the HIV test. You do HAVE to refuse the test if you do not want it. There is not a law that mandates HIV testing in pregnancy. However, your provider's practice may require the test. It is well within your provider's rights to refuse you service if you refuse the test.
:

Also, the reason why HIV testing is encouraged during routine prenatal testing is not simply for the safety of the practitioners. The reason is that if a mother is positive she can be offered treatment during pregnancy and birth that drastically reduces the risk of passing the virus onto the baby.

My personal view, having been an HIV educator is that everyone who has been sexually active should consider getting tested at some point in their lives. There are many women who were in monogamous relationships and still ended up positive.

If you get tested for HIV please ask what their policy is when it comes to obtaining results. When I did HIV testing we always told the client to come back in person for the results because we were not allowed to give their results via mail or through the phone. This was to protect their privacy. Doctors' practices may differ and just not contact you unless the result is positive.

Also, please don't rely on blood donations to be a de facto HIV test. While they will try to contact someone who has tested positive, it isn't always guaranteed that they'll find that person.

ETA:

Quote:
For some reason most doctors never believe any of that, if it comes from me, maybe I am to young (30years old)? They insist, they can only treat me, if I have those tests done. And threaten, that they would assume, that I am HIV+, which would require a CSection.
Again, while having had one monogamous partner indicates a lower risk, it really doesn't say anything about a person's HIV status. The only way to know is to be tested. Also, HIV+ mothers are not all doomed to having required C-sections. Depending upon their viral load (amount of virus in 1cc of their blood) they may be able to have a vaginal birth safely.
post #30 of 65
Quote:
Originally Posted by belltree View Post
For some reason most doctors never believe any of that, if it comes from me, maybe I am to young (30years old)? They insist, they can only treat me, if I have those tests done. And threaten, that they would assume, that I am HIV+, which would require a CSection.

I am not anymore with this office, but those doctors exists.
That sucks. I doubt it's an age thing though. I was 29 when I had my son, that's practically old in terms of maternal age.

I believe that you that those doctors exist, it's one of the reasons I use a midwife and go to the OB that she recommends for backup.

Here is the Texas state code for anyone else in that position. It clearly states that you can opt out.
post #31 of 65
Quote:
Originally Posted by Norasmomma View Post
You can refuse any testing. I refused HIV testing because I already had tested when pg with DD, maybe it varies, but I don't think the state can force a pregnant woman to any testing. I just said I had the test it was negative signed a paper and that was that.

I think it is because it may not show up and they want to check again like that whole wait 6 months and recheck thing if you belive you may have contracted it. I personally do not mind it I no matter what at my anual check get all the STD tests I say why not you are in there anyway I also think that no matter how long you have been with someone say 1 year or 35 you never know I know that is a horrible way to look at something but it is true you can trust them and love them but we are all humans and some may be weak at one point I just want my self checked and then know if it was worst case! My mother always did even after 15 years of marriage she still was checked at every appointment. I think it is all personal preferance my cousin never went to an OB until she got pregnant at 28
post #32 of 65
Thread Starter 
thanks guys i feel so much better now also my nurse told me that dont do a NT scan till 16 weeks UGH i was hoeing for 12 weeks and to find out the sex oh well MORE wait for me lol
post #33 of 65
Quote:
Originally Posted by bajamergrrl View Post
Again, while having had one monogamous partner indicates a lower risk, it really doesn't say anything about a person's HIV status. The only way to know is to be tested.
Hm. Both my partner and I tested at the beginning of our relationship negative. We both went never stray, we never had major surgeries, where could the HIV come from?

Quote:
Originally Posted by bajamergrrl View Post
Also, HIV+ mothers are not all doomed to having required C-sections. Depending upon their viral load (amount of virus in 1cc of their blood) they may be able to have a vaginal birth safely.
I didn't know that, I guess the office was just exaggerating to scare me off.
post #34 of 65
Quote:
Originally Posted by belltree View Post
Hm. Both my partner and I tested at the beginning of our relationship negative. We both went never stray, we never had major surgeries, where could the HIV come from?
I didn't mean to come across as specifically commenting on anyone's relationship. What I was trying to say is that from the tester's POV you can never assume anything about anyone's status without a test. People are not always truthful about their behaviors when it's something this sensitive or unfortunately they may not have truthful partners. Unfortunately I've heard women's stories where thought they were in monogamous relationships, got sick and because they didn't fit a particular "type" or risk profile, their care providers didn't think to test them for HIV. I've done pre-test counseling where one half of a couple is admitting to behaviors that the other half doesn't know about.

My basic point is that if someone is offered a test despite what they've said about their sexual history it isn't necessarily because they're not believed or that they're being judged.

You always have the right to refuse if you're absolutely 100% certain that you are not infected.


Quote:
I didn't know that, I guess the office was just exaggerating to scare me off.
They could have been exaggerating or they could have been clueless. Unfortunately not all health care providers are up-to-date on what's going on with HIV care. If someone's HIV+ it's usually best if they see a doctor who specializes in HIV care because a regular doc just doesn't always have the right information.
post #35 of 65
I'm in California where they just changed the law so that you get the test unless you opt out. After working for 2 years with HIV+ children (all contracted in utero) I was fine with getting it done, I figured I had some risk because of that.
Anyway, I wanted to clarify two things as an RN:

1. All OB's, RN's, MW's, etc should treat their patients as if they could possibly have HIV or something along those lines (Hepatitis for example). I'm not talking about being crazy, I mean it's called Universal Precautions and test or no test all patients are treated the same (like wearing gloves when coming into contact with bodily fluids or washing hands before & after care).

2. They cannot take your baby away and test for HIV against your will. They cannot do anything against your will unless they've somehow involved CPS and gotten a court order, which they are not going to do.

That all being said, I've been in a monogamous relationship for over 7 years, and before that both dh & I were virgins, and he's fabulous and I'd never have any reason to believe he would cheat on me..EVER...and yet I will always get the HIV testing done when pregnant because I just think you never know everything. They can prevent the passage of HIV from Mom to baby in utero almost 100% of the time when everyone is aware of Mom's HIV+ status and certain precautions are taken, so I get the test, just in case I guess. (Plus I have the risk factor of being an RN, so obviously that adds to my concern.)
post #36 of 65
Quote:
Originally Posted by belltree View Post
Well, if you don't take the test your OB or midwife will just treat you as if you have HIV including all the consequences for the birth.
The consequences of having HIV while pregnant are heavy doses of medication and close monitoring of levels in your blood followed by treatment of the newborn. I doubt they would do that. If you mean that they would take precautions around your blood, I would hope that they always do that with every patients, regardless of tests.

Quote:
Originally Posted by belltree View Post
For some reason most doctors never believe any of that, if it comes from me, maybe I am to young (30years old)? They insist, they can only treat me, if I have those tests done. And threaten, that they would assume, that I am HIV+, which would require a CSection.
C-sections are actually a great way to get blood all mixed up and potentially transmit it to the baby. Most babies are safer born vaginally when their mother is HIV-positive, except certain situations.

On another note, I would highly doubt the competence of any HCP who would take your word for it. In my mind, people who swear that they do not have STDs without getting tested go right into a higher-risk category as they likely do not fully understand the potential transmission mecahnisms or are living in wishful thinking mode. I also think that, for someone who "knows" they do not have it, a test for it should not be a big deal.

One thing that does annoy me to no end is all the special requirements involved with HIV testing, such as the lab will not release the results to anyone other than the ordering physician and will only do so by mail (instead of faxing it with the rest). It turns getting tested into a scary, stressful thing and, more importantly, perpetuates the idea that having HIV is deeply shameful and an indicator of someone's character or behaviour.

Edited to add: I might be wrong on this, but IIRC, an HIV test would not be reliable on a newborn.
post #37 of 65
Quote:
Originally Posted by soso-lynn View Post
On another note, I would highly doubt the competence of any HCP who would take your word for it. In my mind, people who swear that they do not have STDs without getting tested go right into a higher-risk category as they likely do not fully understand the potential transmission mecahnisms or are living in wishful thinking mode. I also think that, for someone who "knows" they do not have it, a test for it should not be a big deal.
Just on a side note, because I felt your words put me in a defensive position: I am annoyed by the requests of getting tested, almost every time some health issue comes up. I am annoyed, that if I agree reluctantly to be tested in Dec as part of my annual gyn, I was still asked to be tested again in March as part of my first pregnancy work up.

I have lived in other countries in Europe, and I have never felt as belittled as in the USA through this treatment. All tests ever done to me in the US, because HCP did not believe me, were completely unnecessary and always negative for years now. The tests includeded STD testing (when I was diagnosed with Gilberts, a harmless genetic disorder), pregnancy (when I had pneumonia), drug testing (when I had fainting spells). I never encountered this problem in Europe.

This behavior, that my word is not taking seriously, seems typical for the US, where the doctors are almighty and the patient better complies, because she doesn't know any better. Every time I ask questions at the doctors, mw and doctors comment, that they hardly every have patients asking this many thorough questions. It seems to me people are just used to not feel responsible for their health care, as "doctor knows best". I wonder why doctors in Europe don't seem to have bigger problems with "not enforcing tests" - as far as I know STD rates are not higher there. Just a thought.

Sorry for the rambling - it is just a general problem I have encountered many times over the last decade since I live in the US - there are exceptions, but not that many from my experience.
post #38 of 65
Quote:
Originally Posted by soso-lynn View Post
C-sections are actually a great way to get blood all mixed up and potentially transmit it to the baby. Most babies are safer born vaginally when their mother is HIV-positive, except certain situations.
I had always thought c-sections were safer to avoid any type of disease, but this makes sense regarding HIV. I have heard that other STDs such as herpes can hurt a baby if born vaginally though.
post #39 of 65
Quote:
Originally Posted by soso-lynn View Post
On another note, I would highly doubt the competence of any HCP who would take your word for it. In my mind, people who swear that they do not have STDs without getting tested go right into a higher-risk category as they likely do not fully understand the potential transmission mecahnisms or are living in wishful thinking mode. I also think that, for someone who "knows" they do not have it, a test for it should not be a big deal.
Wow that makes me feel pretty defensive too. I guess that's one of those reason I don't like most HCPs. My husband is a physician and gets tested yearly for HIV and Hep B and the results go in a file in house so I see them, I'm well aware of his status.

As for not wanting the test, I also know there is a higher false positive rate during pregnancy and the stress and other consequences of a false positive are enough to make me decline. There is also the financial aspect of testing. I pay out of pocket for my tests because of the ridiculous $5000 deductible on my insurance, so I decline a lot of "routine" tests (rubella titers for example, doesn't hurt anything to take the test, but regardless of the outcome my behavior/treatment won't change because there is nothing they can do about my titer status while I'm pregnant and I know I was vaxed for it).
post #40 of 65
Quote:
Originally Posted by darcytrue View Post
I had always thought c-sections were safer to avoid any type of disease, but this makes sense regarding HIV.
To which diseases are you referring? STD's only?

Quote:
Originally Posted by darcytrue View Post
I have heard that other STDs such as herpes can hurt a baby if born vaginally though.
It depends. Having herpes does NOT prevent you from having a vaginal birth and a healthy baby. Herpes antibodies are passed to the fetus during pregnancy and protect the baby during birth. Newer infections and infections late in pregnancy are the highest risk as the mother's body doesn't have time to develop and pass the antibodies to the fetus. http://www.herpes.com/pregnancy.shtml
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