WASHINGTONMandatory HIV testing of newborns has not become a
routine practice in the United States, Donna E. Shalala, Secretary of
Health and Human Services (HHS), has ruled.
The Secretary was directed by Congress in the Ryan White CARE Act
Amendments of 1996 to assess newborn HIV testing and to determine
whether it was routine. Had the secretary made such a determination,
states would have been required to meet certain new standards or lose
their Title II Ryan White funding for HIV/AIDS services and medications.
The determination statement, published in the Federal Register, said
that all states have placed a focus on reaching women early in
pregnancy to reduce perinatal HIV transmission and
remarkable success has already been achieved in lowering the
incidence of perinatal transmission of HIV. However, the
Secretary has determined that required testing of newborns for HIV
has not become routine practice in the United States.
Secretary Shalala made her decision on the basis of several lines of
information. One was a study by the Institute of Medicine, which
recommended a national policy of universal HIV testing, but made no
specific recommendation for mandatory HIV testing of newborns.
Another was consultations with state and local officials, public
health experts, and a meeting convened by HHS with eight groups,
which included the National Governors Association, the US Conference
of Mayors, the National Organization of Black County Officials, and
the National Association of State and Territorial AIDS Directors.
A review of HIV testing practices within states revealed that the
states have widely implemented the Public Health Service
guidelines for universal HIV counseling and voluntary testing of
pregnant women and their infants. However, only two
statesNew York and Connecticutmandate HIV testing of
newborns, and Connecticut has not implemented its law, pending the
outcome of a legal challenge to it.
Two other states, Florida and Indiana, give physicians authority to
carry out HIV tests on infants, if they deem it medically necessary,
and Texas requires newborn testing unless the parents object.