Tuesday, January 08, 2008

Mandatory HIV Testing in NJ

Recently I posted a response to mandatory testing on Our Bodies Our Blog website regarding mandatory HIV testing in the state of NJ.

I probably was writing too fast and thinking about what toys the kids were throwing in my lap as I typed, because I did not get my point across very well.

I shall say I am NOT for the state forcing patients to do things they do not want to do. I am for making mandates to make sure patients get the health care they deserve. There are a few issues that concern me about OB/GYN health care and HIV testing.
  1. Physicians in private practice do not always do what the American College of Obstetrics and Gynecologists (ACOG) suggests. They don't always test gonorrhea and chlamydia on all OB patients. They are selective in that for clinic patients they will test, but not private practice. Read into this, I certainly do.
  2. Physicians/clinicians don't always have the time to educate their patients regarding certain tests. A patient will actively decline a test without really being educated about the test. So someone who is offered and declines HIV testing may be refusing because she thinks she is safe. There is the strong probability that nobody spent a significant amount of time educating the patient as to why this test is important. MD's use pre-judgement just as much as the rest of us do. They will pre-judge a patient, or use their own values to help a patient make a decision. For example to to fetal testing or not. This test is often pushed in an OB/GYN office not HIV testing.
So maybe the state mandated HIV testing for a variety of reasons. Cost being one, and also Physician accountability. ACOG recommends HIV testing for all women, not all MD's offer the test.

Also I would like to say that there are many tests that are mandated upon a patient at the hospital level that are regulated by the Department of Health (ie the state). I find it interesting that mandatory HIV testing is so openly discussed, while I have never heard any opposition to other tests being done.

Again, I will reiterate I believe HIV testing should be offered to all pregnant women with the same counseling offered for genetics testing. I do not believe the state has a write to force a patient to do a test if s/he declines.

Hope that clears things up-or opens up the discussion some more.

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