Doctors push HIV testing bill

CARSON CITY -- Doctors and health care officials urged Nevada legislators Wednesday to support a bill that potentially could prevent all babies from being infected with HIV by their mothers.

Dr. Mary Guinan, dean of the School of Public Health at the University of Nevada, Las Vegas, said no babies with HIV were born in Clark County during four consecutive years, and then four were born with the virus last year.

HIV causes AIDS, a disease that has killed more than 25 million people since 1981, according to one estimate.

"We know there are over 200 HIV-infected women of child-bearing age who are not receiving treatment in Clark County," Guinn told the Assembly Health and Human Services Committee.

She called for the committee to approve Senate Bill 266, which states that doctors "shall ensure" pregnant women receive an HIV screening test as part of normal prenatal care.

But the bill allows a pregnant woman to choose not to have an HIV test or other prenatal screening tests.

The bill, co-sponsored by Sen. Steven Horsford, D-Las Vegas, and Assemblyman David Parks, D-Las Vegas, was approved by the Senate 19-0 on April 13.

The seemingly contradictory language is designed to reduce the stigma that a woman might feel in taking an HIV test.

Studies in other states found about 25 percent of women voluntarily took the HIV test when they were told of their right to opt out. When they were told that it was part of normal prenatal care testing but that they still could decline, 94 percent agreed to the HIV test.

During hearings in the Senate, provisions were added that would require a pamphlet be given to pregnant women that explains the test and their right to opt out of testing.

Janine Hansen, president of Nevada Eagle Forum, called the HIV test "a wise thing to do" but said women have the right to reject the test for religious reasons.

The pamphlet is necessary because most women would not be aware of their right to reject the test, she added.

The number of mother-to-child transmissions of the AIDS virus has been reduced through the use of AZT and other anti-virus drugs during the pregnancy and when the mother is in labor.

The Centers for Disease Control and Prevention in 2005 reported 240 cases of mother-to-child HIV transmissions in the United States.

In September, the CDC recommended that HIV testing be part of routine medical tests and that patients not be given opt-out provisions.

"It (HIV) can be treated," Guinan said during the hearing. "It is critical to know the HIV status of the mother."

Guinan formerly worked as chief scientific officer for the CDC and once served as Nevada's state medical officer.

Nevada Trial Lawyers Association lobbyist Graham Galloway said he opposes a clause in SB266 that would free doctors from any liability or discipline if they fail to tell pregnant patients about the HIV test.

"Overall it is a great bill, but that is a grant of immunity," he said. "We oppose any legislation that doesn't hold people accountable."

Galloway added the immunity grant undercuts the whole purpose of the bill because it "essentially says you can ignore the requirements of the statute."

"I tend to agree with you," responded Health and Human Services Chairwoman Sheila Leslie, D-Reno. "Here is the bill, and by the way, if you don't follow it, it is OK with us."

Leslie said she would consider amendments at a future work session of her committee.