Nonanonymous AIDS testing of newborns proposed in New York.

Officials in New York are considering proposals to disclose to mothers the results of human immunodeficiency virus (HIV) tests that its health department currently performs anonymously on all newborns. Like 43 other states, New York screens newborns to track the epidemic, but the samples are not identified.

The proposal to give the results to the mothers would in effect mean mandatory testing for all birthing women and their children, something to which only federal prisoners are now subject. The proposal also conflicts with a current New York state law requiring that people give written consent to and receive counseling before and after testing.

Opponents say the plan unnecessarily violates a woman's right to decide whether to have an HIV test--for herself and her baby--and could lead to broader mandatory testing and more coercive measures. Many fear that mandatory testing could cause women to avoid seeking health care. Even now, some women refuse testing even when HIV counselors contact them, for fear that they might lose their children or suffer discrimination if they test positive.

Opponents say that efforts to expand counseling could achieve the same results. Harlem Hospital has already made counseling a priority and reports that 95 percent of patients agree to be tested after giving birth.

Some opponents complain that the disclosure proposal focuses on women as transmitters of the virus and not as infected people in need of treatment themselves.

The proposal's proponents feel that the interest in providing early treatment outweighs the intrusion on the parents' right to consent to testing and point to routine screening for several genetic disorders like sickle cell disease and hypothyroidism. At the same time, others point out that early detection will create a need for enough funding to provide health care services for currently underserved populations where many infected newborns are likely to be fouod.

The New York legislature is also considering a parallel proposal to evaluate children entering the foster care system for their risk of HIV infection and to test those whose risk is high. Currently, biological parents must consent uoder most circumstances.

New York's anonymous screening indicates that 1,600 to 1,900 of all newborns--less than 1 percent--have tested positive each year since 1987 and that only a third of those actually carry the virus. For the other third, HIV antibodies have crossed the placenta from the mother.

Twenty-nine percent of the nation's AIDS cases among women and 27 percent of those among children come from the state of New York.

--Based on a report from the New York Times, August 8, 1993.