The Centers for Disease Control and Prevention (CDC) has recommended that HIV testing be routinely offered to certain patients in hospitals with high risk of infection (1993) and on all pregnant women (1995). They do not offer guidelines for obtaining consent and guidelines for securing such consent. The focus of this page is on the issue of pregnant women based on information acquired from the article "Routine HIV Testing of Hospital Patients and Pregnant Women: Informed Consent in the Real World.
Testing done on pregnant women has a well-established benefit to the unborn children, but the results affect the mother as well. The advantages of early diagnosis are becoming more important as early treatments are developed. It was found in February of 1995 through ACTG 076 study that the administration of zidovudine after the sixteenth week of pregnancy reduces maternal-HIV transmission. Because of evidence showing that many HIV positive pregnant women fail to acknowledge they may be at risk.
The CDC draft statement about HIV counseling and testing on pregnant women indicates testing should be voluntary and consent should be in accordance with legal requirements where it is performed.
There are moral reasons to adopt policies concerning informed consent. First is that individuals have a right to self-determination. Also, there is the right to privacy to control access to their bodies, including diagnostic procedures.
The guidelines that need to be followed are that patients receive a notice stating they will be asked permission to perform an HIV test at some point during their care. The notice will include all information needed for informed consent. The patient will then be asked permission, and if consent is given, it will be documented. If the patient wants more information, it will be provided by an obstetrician. The patient will be given 48 hours after the blood is drawn to change their mind. There will be no counseling required unless requested or if the result is positive.
Gunderson, Martin.1996. "Routine HIV Testing of Hospital Patients and Pregnant Women: Informed Consent in the Real World." Kennedy Institute of Ethics Journal. 6.2. pp.161-182.