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AMA Calls for Mandatory HIV Testing of Pregnant Women, Newborns

June 27, 1996

CHICAGO (AP) _ In a surprising turnaround on an explosive issue, the American Medical Association on Thursday endorsed mandatory testing of all pregnant women and newborns for the AIDS virus.

The AMA had long favored voluntary testing because there was little doctors could do to treat a pregnant woman infected with HIV. That changed with the realization that the drug AZT can dramatically reduce a woman’s risk of passing the virus on to the fetus.

The issue has remained an explosive one, however, with AIDS activists, civil libertarians and some mothers warning such tests would invade women’s privacy and lead to job discrimination.

The extraordinarily close 185-181 vote by the AMA’s policy-making House of Delegates reflected the fear among many doctors that making the test mandatory would also discourage women most at risk for AIDS from seeking prenatal care.

Those concerns were outweighed by what some AMA members saw as an opportunity to save more newborns from AIDS.

``We have learned enough about the disease to know that the differences in those who are treated vs. those who are not treated cuts by two-thirds the risk to the unborn child,″ said Dr. Robert E. McAfee, an AMA trustee and former president.

AMA policy carries no legal weight, and the group did not specify whether action should be taken at the state or federal level. But with 296,000 members, about half the nation’s doctors, the group’s policies can influence both lawmakers and public opinion.

The vote was immediately criticized by another doctors’ group.

``Mandatory testing will prevent people from coming to see a doctor,″ said Dr. Stanley Zinberg, director of practice activities for the American College of Obstetricians and Gynecologists, which like the American Academy of Pediatrics favors voluntary testing.

Zinberg said he knew of no legal mandate in any state for testing pregnant women. President Clinton signed a law in May that would require mandatory testing of newborns if too few pregnant women agree to voluntary testing.

AMA delegates who supported mandatory testing noted that when AZT is given to HIV-positive mothers starting in the 14th week of pregnancy and also to their newborns for a few weeks after birth, the rate of infected babies drops from 25 percent to 8 percent.

Currently, about 1,600 U.S. newborns get infected by their mothers each year.

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