House Bill Could Require HIV Tests of Newborns

Stepping up federal efforts to combat AIDS among pregnant women and infants, the House on Wednesday approved legislation that eventually could require mandatory HIV testing of newborns--but only if a new drive to encourage voluntary prenatal testing of women fails to reduce the number of infected babies.

The bill, which passed the House on a 402-4 vote, was a compromise with the Senate that broke a months-long deadlock over legislation to extend the Ryan White Act, the principal source of federal funds for AIDS treatment.

The measure requires that states carry out existing government guidelines calling for routine HIV counseling and voluntary testing of pregnant women to qualify for assistance.

Opponents of efforts to require immediate testing hailed the compromise because it postponed mandatory testing until after a five-year effort to promote voluntary testing of pregnant women, which they argue is a more effective way to stem transmission of HIV.

“It was critical to focus our federal resources on voluntary testing of mothers rather than testing newborns when it would be too late to try to prevent most HIV transmission,” said Sen. Nancy Landon Kassebaum (R-Kan.), leading Senate architect of the compromise.

But others were distressed at the inclusion of even a watered-down mandatory testing requirement, which critics say violates the privacy rights of women and may discourage them from seeking prenatal care.

“This proposal starts in the right place and veers off in the wrong direction,” said Alexander Robinson, a lobbyist for the American Civil Liberties Union’s AIDS Project. “The spread of HIV is most effectively controlled by cooperative, rather than coercive measures.”

The compromise is expected to clear the Senate--perhaps as early as today--and be signed by President Clinton.

The Ryan White program, for which Congress provided $738 million this year, provides money for medical care and support services for people with AIDS or who are infected with HIV, the virus that causes AIDS.

The bill requires the secretary of health and human services in 1998 to determine whether HIV testing of newborns had become a standard medical practice. If that is the case, states would qualify for Ryan White funds only if they could show that the number of infected newborns had dropped by at least 50% by the year 2000, or that 95% of pregnant women were being tested. If neither of those goals had been achieved, states would have to require testing of all newborns born to women who have not been tested to qualify.