Mandatory HIV Testing of Newborns Not Routine: HHS

WASHINGTON—Mandatory 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 states—New York and Connecticut—mandate 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.