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HIV Testing for Mothers and Newborns, February 2008
	VT	US
Type of HIV Testing	Opt-out testing of pregnant women	22 States have opt-out testing of pregnant women; 30 have opt-in. 10 States have newborn testing.
Notes	Providers are required to test a pregnant woman for HIV unless she refuses.	The Centers for Disease Control and Prevention recommends opt-out, routine HIV screening of all pregnant women and recommends newborn testing if mother's HIV status is unknown.

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Sources:

Overall Sources: Health Policy Tracking Service, a service of Thomson West at www.netscan.com. NASTAD, Report on Findings from an Assessment of Health Department Efforts to Implement HIV Screening in Health Care Settings; June 26, 2007. Available at: www.nastad.org UCSF, National HIV/AIDS Clinicians' Consultation Center, State HIV Testing Laws Compendium; February 4, 2008. Available at: http://www.ucsf.edu/hivcntr/StateLaws/Index.html State-specific sources (for select cases) Florida 2005 Statute Title XXIX Chapter 384, Section 31. Available at: http://www.leg.state.fl.us/statutes/index.cfm?App_mode=Display_Statute&URL=Ch0384/ch0384.htm. Georgia HIV Pregnancy Screening Act of 2007 (Amends Georgia Code Title 31). Available at: http://www.legis.state.ga.us/legis/2007_08/sum/hb429.htm. Illinois Public Act 095-0702. Available at: http://www.ilga.gov/legislation/publicacts/fulltext.asp?name=095-0702&write=pa Indiana Code Title 16, Article 41, Chapter 6. Available at: http://www.in.gov/legislative/ic/code/title16/ar41/ch6.html Iowa 2007 Revised Code 141A, July 1, 2007. Available at: http://www.idph.state.ia.us/adper/hiv_aids_programs.asp#legislation New York Newborn HIV Screening Program. Available at: http://www.health.state.ny.us/diseases/aids/newborn/index.htm Nevada 2007 Revised Statute 442.640-650. Available at: http://www.leg.state.nv.us/NRS/NRS-442.html#NRS442Sec600 North Carolina Administrative Code Rule Change, November 2007. Available at: http://www.epi.state.nc.us/epi/hiv/regulations.html. Oregon Revised Statute [ORS] 433.017. Available at: http://www.leg.state.or.us/ors/433.html. South Carolina Code SC ST SEC 44-29-120. Available at: http://www.scstatehouse.net/cgi-bin/query.exe?first=DOC&querytext=%22HIV%20test%22&category=Code&conid=3446648&result_pos=0&keyval=850

Definitions:

Current CDC recommendations, CDC, Revised Recommendations for HIV Testing of Adults, Adolescents, and Pregnant Women in Health-Care Settings, Morbidity and Mortality Weekly Report Vol. 55(RR14);1-17; September 22, 2006. Available at: http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5514a1.htm: Pregnant Women: In September 2006, the CDC revised its recommendations for HIV screening of pregnant women in health care settings. The CDC now recommends that HIV screening be part of the routine panel of prenatal screening tests for all pregnant women, unless the patient declines (“opt-out” screening). Repeat screening in the third trimester is also recommended for certain high risk women and for women in jurisdictions with elevated rates of HIV infection among pregnant women. It is also recommended that pregnant women receive oral and written information that includes an explanation of HIV infection, a description of interventions that can reduce HIV transmission from mother to infant and the meanings of positive and negative test results. Newborns: The CDC recommends that newborns be tested for HIV if the mother’s HIV status is unknown. If the mother’s HIV status is unknown at labor, routine, rapid HIV testing is recommended. If the mother’s HIV status is unknown prior to the onset of labor and rapid HIV testing is not done during labor, CDC recommends rapid HIV testing of the infant immediately post-partum. Opt-out HIV Testing of Pregnant Women: HIV test is part of routine prenatal care and pregnant women will be tested unless she refuses (testing will occur unless she “opts-out”). Opt-in HIV Testing of Pregnant Women: HIV test not necessarily part of routine prenatal care and pregnant women must specifically request and/or consent to an HIV test (testing will not occur unless she “opts-in”). In some states, routine offer of HIV testing is recommended. Newborn HIV Testing: Newborn testing is mandatory if mother’s HIV status is unknown or test results not available; some states allow for parent to refuse test on religious grounds. Note that states allowing newborn testing at provider’s discretion were not considered to have newborn testing, as defined here and based on the CDC’s current recommendations.

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