Important note: Information in this article was accurate in 2000. The state of the art may have changed since the publication date.
San Francisco Chronicle - Wednesday, May 24, 2000
David Perlman, Chronicle Science Editor
Because there are no symptoms of infection by HIV, the virus that causes AIDS, no woman can be certain she is uninfected without testing, said the new recommendation by the American College of Obstetricians and Gynecologists to its 40,000 members.
The test should be routinely offered, but not required, said the policy statement, which is in line with recent recommendations by the National Institutes of Medicine and supported by the federal Centers for Disease Control and Prevention.
It marks a significant change from earlier policies which focused primarily on AIDS testing for women "at risk" for the disease -- which includes minority women in impoverished neighborhoods and injection drug users.
The organization is holding its annual convention at Moscone Center in San Francisco this week.
Its president, Dr. Frank C. Miller of the University of Kentucky College of Medicine, said the test for HIV infection should become "as common as blood typing" as a first- line disease-prevention method for every pregnant woman.
Women infected by the AIDS virus have a 25 percent risk of transmitting the infection to their newborn babies -- either during pregnancy and delivery or during breast-feeding. But as Dr. Laura E. Riley of Harvard Medical School said, that risk can be cut to no more than 2 percent, and perhaps even to zero, by early treatment of pregnant women with the panoply of AIDS drugs now available, or by timely surgery when necessary.
Although the doctors recommend that pregnant women be tested during their first prenatal visit to a doctor or nurse-midwife, they recognize that many women may decide not to take the test until very late in pregnancy.
But even during the last 10 days, Riley said, "you can make a difference" in a patient's health and in the chances of infecting her baby by treatment with powerful new anti- viral drugs and by cesarean delivery.
The organization of obstetricians is beginning a major campaign to persuade all its members, as well as other doctors who see pregnant patients, to offer the HIV test as early as possible.
"Our goal is to streamline the process for prenatal HIV testing for both pregnant patients and their doctors," Riley said.
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