PRENATAL HIV SCREENING IN PREGNANT-WOMEN - A MEDICAL-LEGAL REVIEW

Identifying pregnant women's human immunodeficiency virus (HIV) infect ion status provides them with the opportunity to seek appropriate trea tment and to take measures to prevent vertical and horizontal transmis sion. Prenatal screening program options include targeting at-risk wom en, testing on a voluntary basis, or mandating prenatal HIV screening. When examining these options, the number of cases identified, program matic costs, long term health care costs, and legal implications must all be considered. Research indicates that targeting at-risk women mis ses a significant percentage of seropositive women, although programma tic costs may be lower. It is difficult to ascertain the difference be tween voluntary and mandatory programs with respect to the number of c ases identified and treated. As a result, long-term savings are diffic ult to calculate. Mandatory programs would have the greatest direct co sts and place the greatest burden on the woman's constitutional rights . By making HIV counseling and testing a routine component of prenatal care, voluntary programs could achieve the benefits of prenatal HIV s creening without violating the woman's civil liberties.