But AZT alone, while proven effective in this application, isn t the current standard of care for HIV treatment. Studies of the more recent combination regimens are still in the early phases of trials, Shannon said, while researchers attempt to answer questions about dosages and long-term effects. In the meantime, Shannon said, providers can consult the U.S. Public Health Service guidelines, which advise providers to keep maternal health in mind and not focus solely on issues of transmission. Testing debate Success with AZT has been used as an argument in favor of mandatory testing, a highly controversial topic that has become more incendiary since last year, when New York became the only state to un-blind test results of all newborns, Shannon said. This practice effectively tests mothers without consent, say privacy advocates.
Most healthcare providers have mixed feelings on the issue.
Testing as a condition of receiving funds is likely to arise in 2000 because the Ryan White CARE Amendments of 1996 require testing of pregnant women or infants in states where other measures to control HIV have not been met. Ultimately, Shannon said, providers must view HIV as a primary care issue. Although the media has focused on testing during pregnancy, anyone who is sexually active or engaging in risky behaviors should be tested, particularly if considering pregnancy, she said. The focus should be on risk reduction and early intervention, Shannon said. Experts say providers must become educated on speaking with women who have just been diagnosed.