Acquired Immune Deficiency Syndrome or ‘AIDS’ is a serious disease that comprises a number of symptoms, arising due to a breakdown of the immune function of the body. It occurs due to infection with a virus that affects the immune system, known as the Human Immuno-deficiency Virus or ‘HIV’ (CDC. 2005). The virus spreads from one individual to another when contaminated blood, semen, or vaginal secretions from the infected individual comes in contact with damaged skin or mucous membrane of a non-infected individual.
HIV/AIDS was first noticed in California, USA in 1981, and a definite connection between HIV and AIDS was established in 1984. The virus can spread from the infected individual to a non-infected individual by many means, such as unprotected penetrative sexual contact (75%), exposure to contaminated blood or blood products (8%), injecting drug use (8%) and from infected mother to the baby before or during birth, or after birth through breastfeeding (CDC. 2005). In 1999, the CDC observed that out of the 750, 000 AIDS cases reported to them, about 129, 000 were females.
This figure increased from the earlier figure of 64, 000 in 1996, suggesting a 31 % rise (CDC. 2001). To some extent the number of infected cases has been controlled due to the initiation of several HIV programs. The real number of cases of HIV/AIDS in women may truly be greater than this figure. The CDC suggests that about 80 % of the women population affected with HIV may be in the reproductive age, which puts the risk of vertical transmission very high (CDC. 2001). The AIDS epidemic in women has especially targeted several minority groups, such as the Hispanics and the African-Americans (CDC.
2001). About 80 % of all AIDS cases in 1999 were from these groups. In the US, about 6000 to 8000 women affected with HIV gave birth to children before the AIDS Clinical Trial Groups 076 trial. Before this trial, about 1000 to 2000 children were born with HIV positive status. In 2000, this figure reached the 8000 mark. Most of cases were recorded in the minority groups. In other parts of the world, especially the developing countries, the figures are even worse. About 600, 000 children get infected with the disease each year due to vertical transmission of the virus from the mother to the child (CDC.
2001). In 1994, the results of a ground-breaking study demonstrated that the chances of developing HIV infection in the unborn baby were significantly reduced if treatment with anti-retro viral (ARV) drugs were started. During this study (known as the AIDS Clinical Trial Groups 076 or ‘ACTG-076’), about 477 women who tested positive for HIV/AIDS took part in it, and it was seen that the chances of the baby developing HIV/AIDS was reduced by about 67 % if they were treated by administering Zidovudine (AZT).
The drug produced beneficial effects especially when administered during the last six months of pregnancy and during the first six weeks following birth. The results of this study were so significant that the scientific community began to recognize the importance of organizing mandatory testing for all pregnant women (Erin Nicholson. 2002). The number of women who become pregnant each year is about 200 million, and about 1 % of this may be HIV positive (Erin Nicholson. 2002). This ratio is alarmingly high, and we could soon land up with the mother and the child turning out to be HIV positive.
Efforts should be on to provide maternal health services with mandatory testing for HIV/AIDS in the pregnant women, in view of the beneficial findings of the 1994 ACTG-076 study. In this paper, I would be looking at the importance of having mandatory testing for HIV/AIDS in pregnant women. There may be several issues to be considered for imposing mandatory testing of HIV/AIDS for pregnant women. These include legal, ethical, medical, social, health policy, etc. Some of the arguments presented in this paper may be such that they overlap more than one of these fields.