DPH shifts strategy to track AIDS

Health Secretary Joseph Kevin Villagomez is suggesting to adopt the “routine with notification” program in administering HIV test among pregnant women amid legal questions in a mandatory test.

Under this program, Villagomez said, mothers will be informed that a certain test like HIV is a standard part of prenatal care, but they still have the right to refuse it.

“Most women will be tested unless they explicitly opt out. Written informed consent is not necessary, but providers might want to document patient refusals in order to protect themselves from malpractice liability,” Villagomez said in a letter to Rep. Heinz Hofschneider.

“I am proposing, however, that we seriously look at the program of routine with notification as a possible compromise between strictly voluntary and strictly mandatory screening programs. The woman must be explicitly informed of the test, and that she has the opportunity to opt out,” he added.

Hofschneider, chairman of the House Committee on Health, Education and Welfare, has recently introduced House Bill 11-327 which seeks to make HIV testing for pregnant women mandatory aimed at preventing the prenatal transmission of the virus to the unborn child.

But the bill remains pending due to possible legal impediments.

The legislation was hatched after the Division of Public Health announced that a baby girl was born with HIV. Health authorities later found out that both her parents were HIV-positive.

Villagomez said had the mother taken the free HIV testing at the hospital, she could have been given the antiretroviral drug zidovudine (ZDV, previously known as AZT) during her pregnancy. This could have reduced the chance of her child from getting infected with the virus.

“Of the most promising victories in the battle against AIDS was the finding, in 1994, that administration of ZDV, previously known as AZT, during pregnancy and childbirth could reduce the chance that the child of an HIV-positive mother would be infected by two-thirds,” Villagomez said.

The health secretary said he supports the intent of the pending bill. However, he said, the Legislature must also consider that any proposed screening program must conform “to the requirements of the US and the CNMI Constitutions, common laws and statutory provisions.”