AIDS, Women, and the Next Generation: Towards a Morally Acceptable Public Policy for HIV Testing of Pregnant Women and Newborns

The proliferation of Acquired Immune Deficiency Syndrome (AIDS) among women and children represents one of the gravest health issues confronting contemporary society. Women, most of childbearing age, now constitute 11 percent of all cases, and the U.S. Public Health Service has projected over 3,000 cases of pediatric AIDS by the end of 1991. In the face of these sobering statistics, experts have been called upon to grapple with a difficult, compelling question: under what conditions, if any, should HIV testing of women and children be required? Also at issue are the surreptitious testing for HIV antibodies as part of routine prenatal and neonatal examinations, and whether such testing should be performed on all women and infants, or only those who belong to groups judged at "high risk". In this unique contribution to the debate about HIV screening and testing, Ruth Faden, Madison Powers, and Gail Geller have assembled perspectives from experts in public health, medicine, law, and ethics. Their wide-ranging treatment examines the history of prenatal and neonatal screening programs; informed consent; legal issues and confidentiality; reproductive decision-making; and numerous other aspects of HIV testing. Alternative policy options for both now and the future are discussed in detail. This volume provides a comprehensive analysis of these pressing medical, public health, legal, ethical, and social issues, and is essential reading for AIDS researchers and clinicians, public health specialists, ethicists, health policymakers and analysts, obstetricians, and pediatricians.