Routine HIV Pregnancy Tests Urged

More widespread HIV testing among the general public, but especially for pregnant women, was strongly advocated Tuesday by AIDS experts during the second day of an Orange County conference on the disease.

“All HIV-infected people must be identified” so that they can be taught how to prevent the spread of the disease and be provided with medical and social services, said Dr. Don Francis, a longtime researcher of acquired immune deficiency syndrome.

Dr. Alexandra Levine, professor of medicine at USC who is the principal investigator in a nationwide study of women with HIV infection, said she favors “testing of all pregnant women because the transmission rate of HIV (from mothers) to infants is 30% and can be significantly decreased” if the mothers take the antiviral drug AZT.

Both physicians gave their views on testing during longer presentations to a conference forum and in interviews later. However, neither they nor others at the annual AIDS conference held at the Red Lion Inn in Costa Mesa called for mandatory testing, citing the fear and stigma that attaches to those who test positive for HIV.

Dr. Melvyn Sterling, president of the Orange County Medical Assn., endorsed the expansion of testing, saying society “should err on the side of testing more and not testing less.”

But in an interview at the conference, he too noted the problem of stigmatization. “There is tremendous fear out there,” said Sterling, adding that the fear is reinforced by instances where people with HIV have lost jobs and medical insurance.

“If there were no downside, we would test everyone,” said Sterling, who instead advocates testing for those at high risk for the disease, including intravenous drug users, gay men with multiple partners and women who have sex with bisexual men.

In making her argument for routine testing of pregnant women, Levine pointed to a federally sponsored study that found that giving AZT to HIV-infected pregnant women can dramatically reduce the transmission of the disease to the fetus.

Several thousand children have contracted AIDS since the epidemic began in 1981.

Levine said she would go a step further, recommending women be tested when they are planning a pregnancy.

“Women do all kinds of things to be as healthy as possible when they are thinking of becoming pregnant, such as stopping smoking, cutting down on drinking alcohol and cutting down on medicines . . . and an HIV test would be part of that,” she said.

Levine favors routine testing of pregnant women because the virus has spread beyond the high-risk groups. Research has found that if only pregnant women considered at high risk for AIDS are tested, half of the women with the virus will be missed, she said.