A concern with voluntary testing is that some HIV-positive women will not be tested. As a result these women will not receive the treatment and services they need to combat the disease and protect their baby. The American College of Obstetricians and Gynecologists, and the Centers for Disease Control and Prevention as well as the Minnesota Department of Health and the Minnesota Medical Association recommend routine counseling and voluntary HIV testing of pregnant women. Under a program of mandatory testing, all pregnant women receive an HIV test with or without their consent. This option would result in the testing of all women who receive prenatal care.
Mandatory testing raises a number of health care, legal, and ethical concerns.
In addition they may fear the financial hardships and stigma that some HIV-positive persons face. Mandatory HIV testing may also place individual rights of adults at odds with the special role of the state in protecting the health and safety of children. As noted earlier, the most effective way of decreasing transmission of HIV from mother to infant is to begin treating the mother during pregnancy. If testing does not occur until after the birth of an infant, critical delays in treatment for both the mother and the infant have already occurred. These delays mean that the infants of infected women have a greater chance of developing HIV themselves.