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Mandatory HIV testing - Page 2

post #21 of 107
I have so many problems with this, especially since pregnancy is listed as a "condition" that causes false positives. Sure, you could say just test again when baby is here, but in the meantime it's a high possibility that authorities (CPS, courts, etc.) could get involved and not allow mom to nurse. Just read some of the articles on MDC about it. It's quite scary.

I don't know if it was a law in Texas when I was pregnant 4 1/2 years ago, but my mw gave me the option. I didn't know much then so opted for it. In the future I will turn it down but be tested before I TTC.

Not to mention the whole testing process is a joke. There are two main forms of testing but they vary from tech to tech so one could say the same sample is + while another could say it's -.
post #22 of 107
I'm not even sure why this is mandatory tbh unless there was an exposure to the hcp? The providers should be using universal precautions so there should not be a 'risk' of them catching it. It's not as if the hcp can force treatment on a patient nor should they be able to.

We don't require mandatory HIV testing for routine visits for any other condition.
post #23 of 107
Quote:
Originally Posted by KarlaC View Post
I'm not even sure why this is mandatory tbh unless there was an exposure to the hcp? The providers should be using universal precautions so there should not be a 'risk' of them catching it. It's not as if the hcp can force treatment on a patient nor should they be able to.

We don't require mandatory HIV testing for routine visits for any other condition.
Actually in some areas they CAN legally force treatment for HIV {as well as TB}.

Public health issue.
post #24 of 107
Doesn't bother me personally.
post #25 of 107
Quote:
Originally Posted by MaterPrimaePuellae View Post
The midwife told me this was the case in SC as well. The whole thing makes me pretty angry, too
Wow, is it? I don't remember having to be tested for this.
post #26 of 107
Quote:
Originally Posted by frugalmama View Post
Actually in some areas they CAN legally force treatment for HIV {as well as TB}.

Public health issue.
Where is that at? Unless you're judged incompetent to make your own decisions I've never heard of forced HIV treatment in the states.
post #27 of 107
Why is "forced" HIV testing any different than all the other "forced" blood screenings that babies are put through (PKU+ screenings)? (Other than you can forgo it by having yourself tested before the birth.)

Seems to me it is the same thing. (Not that I agree with all the requirement of PKU screenings, but most MDC Moms so, so it would seem reasonable to chalk this one up to the same thing; the "best" interest of the baby.)

And though some statest allow certain exemptions on newborn screenings, not all do. Not to mention the over all concensus here that you should not exempt out because it could be harmful, even fatal, for the baby.
post #28 of 107
WOW, this is definitely NOT the law here in WA, and I'd be pretty angry if I was told that I am forced to do just about anything. Totally not okay.
post #29 of 107
When I had my physical last year, they took a blood draw and didn't inform me that they were going to do an HIV test. They just said they were doing a couple other tests, like my blood count and whatever. They just told me afterwards that I was HIV negative. I wasn't even pregnant either!!! ( *altho I think it was because I went to the health dept..)
It did bother me. It's my blood, my body and what happens to it and in it is my business. I really don't see what the hype is still all about, people with HIV are living just as long and complete lives, in many cases, as those who don't have it. ( And I do know a couple of people who are HIV +)
post #30 of 107
Quote:
Originally Posted by MegBoz View Post
Ok, so should women be tested on a monthly basis then? Presumably, if they continue to be in a relationship, they'll have sex throughout the pregnancy & could contract it then.

How about Herpes? That can be trasmitted to the baby during birth, so should women be tested monthly for that as well?

Honestly, that is just ridiculous. If you're having sex with a partner, you MUST trust them. You could be wrong, but you as the mother have the right to decide to get tested "just in case." As another poster wrote, your HCPs could release you as a patient & decline to care for you if you refuse. But you still can't, and shouldn't be forced.

No provider or anyone should make you feel paranoid & perpetuate a belief system that would shatter the foundations of marriage (if you're telling me I ought not to trust my husband, they you're endermining my whole marrige.)

I got tested with my DS because I don't mind blood being drawn & they were doing it for other stuff anyway. I will refuse whenever we conceive #2. And if some HCP encouraged me to do so "just in case your DH has cheated" I would take offense to that.
I trust my husband very much, but I still got HIV testing and chlamydia and gonorrhea testing at my first midwife appt. I have a friend who found out her husband cheated one week and the next found out she was pregnant. It was VERY MUCH a concern that he could have given her something (luckily he didn't.) And up until the moment she found out about his extra-marital affair, she trusted him 100%.

And actually, I don't care if people don't get the testing and I don't know if I agree with a law that makes it mandatory, I just wanted to point out that RedPony really doesn't have zero chance of being infected with HIV unless she had IVF done to get pregnant, because pretty much every other way requires you to have sex, thus giving you a chance that you could have acquired HIV.
post #31 of 107
Quote:
Originally Posted by KarlaC View Post
I'm not even sure why this is mandatory tbh unless there was an exposure to the hcp? The providers should be using universal precautions so there should not be a 'risk' of them catching it. It's not as if the hcp can force treatment on a patient nor should they be able to.

We don't require mandatory HIV testing for routine visits for any other condition.
Because it's not to protect the hcp; it's to protect the baby.
post #32 of 107
Quote:
Originally Posted by elmh23 View Post
How do you know that there was no chance? Presumably you had sex to get pregnant, which is a way to contact HIV. While you trust your partner, they might be seeing someone on the side that you don't know about. This is one of the ways HIV is transmitted.
Um. One partner for me. One partner for him. Ever. Thanks for the PSA on mistrust in marriage, tho. I'll take that into consideration.

Quote:
Originally Posted by soso-lynn View Post
I think that you have the right the refuse the test. However, that kind of attitude is just ignorant. I work at a fertility clinic and we have to test every patient whose reproductive material will be in our lab for the whole slew of STDs and other diseases. Most people who get positives are people who think they had zero chance.

In the past several years, it has been noticed that the groups that are getting more and more STDs are people considered low risk. Many doctors have focused their attention on people they considered high-risk and might have not offered testing for their middle-aged, married patients. Studies on this looked at chlamydia, gonorrhea and such but it would likely old true for other STDs as well.
Why is it that my view is any less valid then yours? Of course I have the right to refuse this test, so should everybody. That does not make me ignorant, however you want to color it, and I find it condescending that you'd say that. I'm not a fertility clinic patient, so your anecdote is just that...

(why do I bother? )
post #33 of 107
It may be true that nobody has absolutely zero chance of having HIV, but it is also impossible to have zero chance of a false positive result, with all that follows. It is a matter of weighing the risks, not choosing risk over no-risk.
post #34 of 107
Quote:
Originally Posted by RedPony View Post

Why is it that my view is any less valid then yours? Of course I have the right to refuse this test, so should everybody. That does not make me ignorant, however you want to color it, and I find it condescending that you'd say that. I'm not a fertility clinic patient, so your anecdote is just that...
My point was that magical thinking is ignorant, blind trust is ignorant and thinking that only a certain kind of people get HIV is ignorant. Do you really think that most people whose partners are cheating or doing drugs or whatnot know or are any different from you? If you feel so strongly that trust should substitute labwork, are you suggesting that people who believe they are not at risk should be able to give blood without getting tested?

Also, as I have said before, false positives do not have any horibble consequences because the tests that do give occasional false positives are SCREENING tests, not used to diagnose, but rather to find out if further testing is needed. The worst imaginable outcome in case of a false positive is if you need to provide a new sample and wait for results. In most cases anyway, even the initial positive result would appear as a possible false positive. If the cut-off for a postive is, say, 1.5, you would have a positive at 1,6. However, someone who truly has HIV would normally get a 40 or 50 on the same scale. So, even if a positive did come up, you usually have a pretty good idea even before the confirmation tests are done.

So, once again, NO ONE would EVER get any kind of treatment or diagnosis before confirmation tests clearly indicate a positive.

Seriously, it is almost 2010, I expect people to get over the 80s fear and stigma around HIV and start treating it like any other disease.
post #35 of 107
Quote:
Originally Posted by soso-lynn View Post
So, you are actually saying that it would be acceptable for a doctor or midwife to refuse care if someone did not want to get tested. I find that equally as horrible as a law requiring testing.
No! I'm not saying I personally find it "acceptable" for a HCP to refuse care. BUT... that is their choice!

I don't find it anywhere NEAR as horrible as a law requiring testing because the law removes the mama's choice! Removing choice is always bad, period.

So it is not a reasonable argument to justify the law requiring testing by saying: The law is there to protect the HCP. No! The HCP can protect themselves, if they want, but refusing care to un-tested Mamas. THAT is the solution. NOT an unconstitutional law that removes choice from mamas!
Does that make sense?

Quote:
Originally Posted by soso-lynn View Post
Doctors HAVE to treat people and give them the opportunity to make decisions on every aspect of their care. They canot just get rid of patients who disagree.
Actually, I could be wrong, by my understanding of 'patient abandonment' is this:
1. If a HCP wants to dismiss a patient, he must make sure she DOES have other care. (So he can't dump her till she gets into the care of another HCP)
2. He also can't dump her while she's in imminent need. i.e. He can't dump her while she's in active labor, until she is "stable" - defined as delivery of both baby & placenta

Since HIV testing is traditionally done during the 1st trimester, she's not in 'imminent need' so he totally could say, "OK, I'm giving you ample warning, get the test or you need to get care elsewhere." I do think that would be perfectly legal.

Quote:
Originally Posted by soso-lynn View Post
If getting tested for HIV would shatter your marriage, then your marriage has a problem regardless. No one is telling you not to trust your husband, just not to put that blind trust above the health of your children.
Ay yi yi! I did not say that getting an HIV test would shatter my marriage. I said, "Telling me I ought not to trust my DH would undermine my marriage." Um, isn't it true that trust is the foundation of marriage?

Besides, again, the HIV test is done during the 1st trimester. I would think most married couples have sex at least a few more times between the 1st trimester and delivery, so um, don't you STILL have to "just trust your DH not to cheat"?????
post #36 of 107
Quote:
Originally Posted by soso-lynn View Post
My point was that magical thinking is ignorant, blind trust is ignorant and thinking that only a certain kind of people get HIV is ignorant.
Uh, you need to look into the definition of "Blind trust." Blind trust means you are blind - so you can't see- but you trust anyway. "Blind/can't see", means you aren't educated about the person/thing you are trusting. You don't really know about them, but you trust anyway.

I know my husband. I trust my husband. That isn't "blind" trust.

As a matter of fact, calling a woman's trust of her DH "Blind" trust is an ignorant statement.

My DH would realize he could jeopardize the health of me & the baby if he cheated. I trust him with our lives. If he cheated, he'd fess up & tell me so we could all get tested. He would no more endanger the lives of his wife & child by keeping cheating a secret than he would endanger our lives by other actions. I trust him not to do stupid, damaging things like smother the baby under a million blankets, or leave him alone in the bathtub. It's the same thing. I trust him with our lives.

**However I do agree with you that saying, "Only certain types of ppl get HIV is ignorant."
Quote:
Originally Posted by soso-lynn View Post
If you feel so strongly that trust should substitute labwork, are you suggesting that people who believe they are not at risk should be able to give blood without getting tested?
That analogy is totally nonsensical. I don't trust strangers, nor do I expect them to trust me. So OF COURSE I would expect a stranger to want MY blood tested before accepting a transfusion for me! Totally different scenario here. This analogy is not applicable at all. (Refer back to "blind trust" - taking blood donations from strangers is "blind trust." I don't advocate blind trust.)

Quote:
Originally Posted by soso-lynn View Post
Seriously, it is almost 2010, I expect people to get over the 80s fear and stigma around HIV and start treating it like any other disease.
This isn't about fear & stigma. Again, do you think women should be screened again late in pregnancy? What about those DH's' who are cheating during the pregnancy? if you think we can't trust our partners, then why do you think a 1st trimester screening ONLY is sufficient? Do you see my point? How far do you think we should take this distrust? Don't we HAVE TO have some level of trust??
post #37 of 107
Wow, this is an interesting thread. Just to throw a few things out there:

Health care providers are supposed to follow "Universal Precautions," which basically means maintaining a level of self-protection that would prevent transmission of HIV (or Hep B or any number of infections) regardless of the woman's status. In theory your HCP has no grounds saying s/he is safer if you test. In practice, birth is messy and exposure is common...but that's no excuse. They are supposed to act the same whether you are positive or negative.

There have been studies done on paternity, where in a random population sample, just under 10% of the babies were not actually fathered by the person the mother named. Different studies say different things, but the true range seems to be around 5-10%. Compound this with male infidelity and you wind up with, at the very most conservative, 10% of the population having exposures they're not admitting. Health care providers have good reason to doubt fidelity. Yes, it's true, *most* couples are faithful. But in a large practice, if statistics hold true, you're going to run into at least a couple of people per year who are at risk and either don't know it or aren't admitting it.

In WA state the laws regarding HIV testing recently changed, and the way things are written has made it sound like providers can tag HIV testing on to prenatal panels without explicit consent (where it used to be that HIV testing had its own separate informed consent documentation and signature pages). All the MWs I know are still offering HIV testing specifically, but I can imagine a lot of docs offices are just putting HIV testing on their standard panels the way they do other less controversial tests.
post #38 of 107
I don't think it's mandatory over here, but I was offered a full blood test for everything, including HIV and many other diseases and I thought it was a good precaution. Not that I thought I had any reason to have anything, but you never know, and I didn't want to put myself, my baby or any others who are helping with my birth at unnecessary risk.

Turns out I'm negative for everything. I don't think it's a bad thing to test. And I think it's strange if testing creates any bad feelings in a relationship. If you're both loyal to each other then what's the problem?
post #39 of 107
Quote:
Originally Posted by Juniperberry View Post
I don't think it's a bad thing to test.
I agree! It's legally-mandated testing I have a problem with.

Quote:
Originally Posted by Juniperberry View Post
And I think it's strange if testing creates any bad feelings in a relationship. If you're both loyal to each other then what's the problem?
Either of us getting tested isn't a problem.
The problem is in this hypothetical future discussion (whenever I conceive #2 & meet with the HB MW I've chosen.)

So my MW says, "Meg, you should get tested."

"Well, I did with DS, & I don't feel the need to be re-tested at this point now with baby #2."

"What, why?"

"Well, neither DH nor I have had sex with anyone else. & we certainly don't do IV drugs or engage in any other activities that could have made us contract HIV."

"But, Meg, how do you KNOW your DH has been faithful?"


"Uh, I trust him."

"Don't 'blindly' trust your DH! He could cheat & you wouldn't know."



It is these statements in red, which basically are the things soso-lynn has written on this thread, that would anger me. If I WERE to agree with the MW and think, "Gee, i CAN"T trust my DH!" than THAT would be damaging to the relationship.
  • It is not me getting tested that would damage the relationship.
  • It is not my MW suggesting I get tested that would damage the relationship.
It is the MW suggesting I can not, and should not trust my DH that would damage a relationship. (Well, it would 'damage' it if I agreed with her, which I would not.)

Now, if the MW just said, "I'm sure you are right, I'm sure your DH is a wonderful man, but I think it's always better to be safe than sorry. You're going to have blood drawn anyway so we might as well just test. It won't hurt anything."

Now THAT, THAT statement, I would say "OK, sure, no problem!"

See the difference?

Compare & contrast the purple & red statements. Telling women they can't/shouldn't trust their husbands/partners is not a good idea. I would EXPECT that message to be met with resistance. it SHOULD be met with resistance because you DO need to trust your DH!
post #40 of 107
In FL, at least, the statutory requirement for HIV testing does include an opt-out. The client must just state that they do not wish to have the test performed.

I'm not remotely opposed to the testing, by the way. The couple of times I've been stuck by a needle and/or splashed with fluid (VERY common at births) looking back at that lab result for HIV and HepB made me feel SO much better. It's just good information for your careprovider to have.
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