Only 19 states have adopted laws or regulations concerning HIV testing and counseling of pregnant women. As of June 1998, only the states of Idaho, Kansas, and Vermont have not passed laws or set policies regarding testing and counseling of pregnant women. In four states, Michigan, Mississippi, Tennessee, and Texas, a woman will be tested unless she specifically objects. Nevertheless, a woman often may not know that she has that option. Even if a woman refuses an HIV test, her newborn may be tested without her permission.
Mandatory testing runs up against several barriers.
As a public policy matter, some pregnant women who know that they must undergo an HIV test may avoid settings, like hospitals, if they know that they will be tested. In avoiding these settings, these women would miss out on prenatal care and prenatal counseling. Even if a woman agrees to the test and tests HIV-positive, there is no guarantee that she will accept the AZT prophylactic treatment or adhere to the treatment regime. Testing for HIV, as any other invasive procedure, should require the patient's consent. HIV testing laws of many states require a patient's informed consent.